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Notkun geislavirkra 198Au korna og ytri geislunar í meðferð óskurðtækra lungnakrabbameina

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Authors
Steinn Jónsson
Sigurður Árnason
Eysteinn Pétursson
Sigurður Björnsson
Issue Date
1997-09-01

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Other Titles
198Au brachytherapy and external radiation compared with external radiation only in non-small cell lung cancer
Citation
Læknablaðið 1997, 83(9):775-80
Abstract
Objective: In this study the effect of a combination of radioactive gold (198Au) grain implantation and external radiation on survival and quality of life in patients with non-small cell lung cancer (NSCLC) and endobronchial lesions was compared to treatment with external radiation only. Material and methods: Patients with NSCLC who were inoperable because of intrathoracic tumor spread or poor functional status, were randomized to receive either brachytherapy with 198Au implantation followed by external radiation with an intended maximum dosage of 60 Gy (group A), or external radiation only (group B). Time spent in hospital was used to reflect quality of life. Results: There was no difference in age or performance status at entry into the study. Five of 10 patients in group A had squamous cell carcinoma as did five of eight patients in group B. The mean dose of external radiation was 46.6±4.0 Gy in group A and 54.8±2.8 Gy in group B (NS). Median survival among group A patients was 29 weeks and 30 weeks in group B. Patients in group A spent 7.4±2.8 weeks in hospital whereas patients in group B spent 18.5±9.0 weeks in hospital. This difference was not statistically significant (p=0.21). Conclusion: We conclude that the addition of brachy-therapy using 198Au gold grains did not improve significantly the results of standard radiotherapy in this randomized trial of patients with inoperable NSCLC.
Tilgangur: Í þessari rannsókn voru könnuð áhrif þess að nota saman geislavirk 198Au korn og ytri geislun á lifun og lífsgæöi sjúklinga með lungnakrabbamein önnur en smáfrumukrabbamein í samanburði við meðferð með ytri geislun eingöngu. Efniviður og aðferðir: Sjúklingum með lungnakrabbamein önnur en smáfrumukrabbamein sem voru óskurðtæk vegna útbreiðslu innan brjóstkassa eða annarra almennra frábendinga var á slembaðan hátt skipt í tvo hópa. Annar hópurinn (hópur A) fékk meðferð með 198Au kornum og síðan ytri geislun, allt að 60 Gy, en hinn hópurinn (hópur B) fékk ytri geislun eingöngu. Þörf fyrir sjúkrahúsvist var notuð til þess að endurspegla lífsgæði. Niðurstöður: Það var enginn munur á aldri eða lífsgæðastuðli við upphaf rannsóknarinnar. Fimm af 10 sjúklingum í hópi A höfðu flöguþekjukrabbamein og fimm af átta sjúklingum í hópi B. Meðalskammtur ytri geislunar var 46,6±4,0 Gy í hópi A og 54,8±2,8 Gy í hópi B (NS). Miðgildi lifunar sjúklinga í hópi A var 29 vikur en 30 vikur í hópi B. Sjúklingar í hópi A dvöldust að meðaltali 7,4±2,8 vikur á spítala en sjúklingar í hópi B dvöldust 18,5±9,0 vikur á spítala. Þessi munur var ekki staðtölulega marktækur (p=0,21). Ályktanir: Við ályktum að viöbót hefðbundinnar geislameðferðar með 198Au kornum bætti ekki marktækt árangur hefðbundinnar geislameðferðar í þessari slembuðu rannsókn á sjúklingum með óskurðtæk lungnakrabbamein önnur en smáfrumukrabbamein.
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