Zhongguo linchuang yanjiu (Jun 2023)
Utrasound and bronchoscopy-guided 125 I seed implantation combined with β-elemene on treating advanced mediastinal lung carcinoma
Abstract
Objective To explore the clinical effect of utrasound and bronchoscopy-guided iodine-125 ( I-125) radioactive seeds implantation combined with β-elemene in the treatment of advanced mediastinal lung carcinoma. Methods A total of 120 patients with advanced mediastinal lung carcinoma in Chongqing Traditional Chinese Medicine Hospital from September 2017 to January 2021 were enrolled and divided randomly into I-125 seeds group, β-elemene group and combination group (I-125 seeds + β-elemene) according to the treatment method (n=40, each) . The short-term clinical efficacy, serum tumor markers, distant metastasis and 1-year survival were compared among three groups . Results At 2, 4 and 6 months after treatment, the curative effects of combination group and I-125 seed group were significantly better than those in β-elemene group (P＜0.05) . Compared with those before treatment and in β-elemene group, the airway diameter, percentage predictive forced expiratory volume in first second (FEV1%) and 6-min walking distance (6MWD) increased, and the shortness of breath index decreased significantly in combination group and I-125 seed group at 2, 4 and 6 months after treatment (P＜0.05) . In combination group, the serum levels of carcinoembryonic antigen (CEA) , squamous cell carcinoma antigen (SCC) and cytokeratin 19 fragment (CYFRA 21-1) and tissue peptide antigen (TPA) were lower than those before treatment (P＜0.05) , and the maximum cross-sectional area of the lesions significantly reduced at 4 months after treatment (P＜0.01) . After 1 year follow-up, the survival rate in combination group (87.5%) was higher than that in I-125 seeds group (62.5%) and β-elemene group (52.5%) (P＜0.05) . Conclusion In the treatment of patients with advanced mediastinal lung carcinoma, ultrasound and bronchoscopy-guided I-125 radioactive seeds implantation combined with β-elemene is an effective, safe and feasible measure, with good short-term prognosis, which is superior to single I-125 radioactive seeds implantation and alone use of β-elemene. It has been confirmed that β-elemene has radiosensitization effect and synergistic anti-tumor effect when combined with I-125 radioactive seeds implantation.
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