基于影像组学探讨CT引导下¹²⁵I粒子治疗中晚期肺癌的疗效评估

Radiomics-Based Evaluation of Therapeutic Efficacy of CT-Guided ¹²⁵I Seed Implantation for Advanced Lung Cancer

摘要: 目的：基于影像组学技术分析中晚期肺癌患者CT影像潜在特征，评估CT引导下¹²⁵I植入治疗的临床疗效，为中晚期肺癌患者个体化治疗方案的制定及疗效预判提供循证依据。方法：纳入2020年1月~2025年1月150例行CT引导下¹²⁵I治疗的中晚期肺癌患者为观察组，收集患者治疗前1周内的胸部增强CT影像资料，经影像组学分析软件分割肿瘤病灶并提取特征，基于多步骤筛选构建影像组学标签，通过比较生存差异分析影像组学标签与临床疗效的关联。选取同期在我院确诊并接受常规化疗的中晚期肺癌患者150例作为对照组，对比两组临床疗效。结果：观察组150例患者均成功完成¹²⁵I植入治疗，粒子植入准确，术后放射性粒子治疗计划系统剂量验证结果提示符合处方剂量要求，术后6个月客观缓解率为71.33%，疾病控制率为94.00%，显著高于对照组53.33%、80.66%，P < 0.05。经特征筛选获得8项与治疗疗效密切相关的影像组学特征信息并构建标签，观察组患者中高标签评分组患者客观缓解率、疾病控制率、中位无进展生存期、总生存期均显著优于低标签评分组，P < 0.05。结论：CT引导下¹²⁵I治疗中晚期肺癌定位精准、疗效可靠，有利于控制肿瘤进展，延长患者生存时间，基于治疗前CT影像组学标签能够有效区分不同疗效预后人群，为中晚期肺癌病人个性化治疗方案的制定提供重要的参考价值。

Abstract: Objective: To analyze the potential features in CT images of patients with advanced lung cancer based on radiomics technology, and to evaluate the clinical efficacy of CT-guided ¹²⁵I seed implantation therapy, providing evidence-based support for formulating individualized treatment plans and predicting therapeutic outcomes for these patients. Methods: A total of 150 patients with advanced lung cancer who underwent CT-guided ¹²⁵I treatment from January 2020 to January 2025 were included in the observation group. The chest enhanced CT imaging data of the patients within one week before treatment were collected. The tumor lesions were segmented and features were extracted using the image biomarker analysis software. Based on multi-step screening, an image biomarker label was constructed. The association between the image biomarker label and clinical efficacy was analyzed by comparing survival differences. A total of 150 patients with advanced lung cancer who were diagnosed in our hospital and received conventional chemotherapy at the same time were selected as the control group. The clinical efficacy of the two groups was compared. Results: All 150 patients in the observation group successfully completed the ¹²⁵I implantation treatment, and the particle implantation was accurate. The dose verification results of the postoperative radiotherapy planning system indicated compliance with the prescription dose requirements. The objective response rate at 6 months after surgery was 71.33%, and the disease control rate was 94.00%, which was significantly higher than that of the control group (53.33% and 80.66%, respectively), P < 0.05. Eight imaging biomarker features closely related to treatment efficacy were selected through feature screening and a label was constructed. The patients in the high-label-score group in the observation group had significantly better objective response rate, disease control rate, median progression-free survival, and overall survival than those in the low-label-score group, P < 0.05. Conclusion: CT-guided ¹²⁵I seed implantation for advanced lung cancer is characterized by precise localization and reliable efficacy, facilitating tumor progression control and prolonging patient survival. The pre-treatment CT-based radiomics signature can effectively differentiate patient populations with different prognostic outcomes, providing significant reference value for developing personalized treatment plans for patients with advanced lung cancer.