^(32)P玻璃微球血管栓塞内照射加局部灌注抗癌药对肺癌的治疗作用

Phosphorus-32 glass microspheres radioembolization combined with anticancer drugs regional perfusion for lung cancer

目的 :探讨3 2 P玻璃微球 (phosphorus 32 glassmicro spheres,3 2 P GMS)经支气管动脉栓塞内照射治疗支气管肺癌的有效性和安全性 .方法 :经病理确诊的 2 4例支气管肺癌患者均接受 2个周期的全身化疗 .非小细胞肺癌 (NSCLC)采用CAP方案化疗 ;小细胞肺癌 (SCLC)采用EP方案化疗 . 4wk为一周期 .所有患者均于第 8周后复查胸部CT ,在证实其病灶变化不明显后行支气管动脉局部灌注化疗并以3 2 P GMS与超液化碘油的混悬液进行栓塞 .于第 12周观察治疗前后胸部CT影像学改变、临床症状、副作用及介入并发症等发生率 .结果 :3 2P GMS支气管动脉超选择性介入栓塞内照射术治疗肺癌疗效显著 ,完全缓解 (CR) 5例 (2 1% ) ,部分缓解 (PR) 15例(6 2 % ) ,稳定 (SD) 3例 (12 % ) ,进展 (PD) 1例 (4% ) ,有效率(CR +PR) 83% ;除 1例出现一过性脊髓缺血 ,经积极治疗后好转外 ,未见其他并发症 .结论 :全身化疗后序贯3 2 P GMS肿瘤血管支栓塞内照射加局部灌注化疗治疗支气管肺癌有较高的近期缓解率 ,患者耐受良好 ,是治疗肺癌安全、有效的方法之一 .

AIM: To evaluate the efficacy and safety of using phosphorus-32 glass microspheres ( 32P-GMS) as a radioembolizer in patients with lung cancer. METHODS: Twenty-four patients with intermediate and advanced lung cancer confirmed by histology were enrolled in the study. All of the patients received 2 cycles of systemic chemotherapy: cyclophosphamide+adriamycin+platinum (CAP) regimen for patients with nonsamll-cell lung cancer (NSCLC) and etoposide+platinum (EP) regimen for patients with small-cell cancer (SCLC). At the 8th week, all the patients, who were confirmed to have no obvious morphological changes of tumor by chest CT, were given regional perfusion of anticancer drugs combined with 32P-GMS radioembolization. The changes of CT image, clinical symptoms and side effects after therapy were observed. RESULTS: Twenty-one percent (5/24) of the patients achieved complete remission, 62% (15/24) of patients achieved partial remission, 12% (3/24) of patients had no real changes and 1 patient deteriorated. The treatment was well tolerated, only 1 case showed short-term ischemia of the spine cord. CONCLUSION: Sequential therapy with systemic chemotherapy followed by phosphorus-32 glass microspheres radioembolization combined with regional perfusion of anticancer drugs for advanced lung cancer is feasible and safe.