经纤维支气管镜介入治疗晚期非小细胞肺癌

Local therapy by fibrobronchoscopy for patients with advanced non-small cell lung cancer

目的观察经纤维支气管镜(纤支镜)微波治疗、局部化疗并全身静脉化疗晚期中央型肺癌患者的疗效。方法将64例晚期非小细胞肺癌(NSCLC)随机分为治疗组(32例)与对照组(32例)。治疗组采用OlympusBF-P30纤支镜介入治疗(微波治疗及NM-3K型注射针注入丝裂霉素12mg)并MVP方案全身静脉化疗。对照组单纯用MVP全身静脉化疗。结果治疗组32例中,完全缓解(CR)12例,部分缓解(PR)17例,稳定(SD)2例,疾病进展(PD)1例,有效率(CR+PR)90.6%;对照组32例中,CR3例,PR15例,SD10例,PD4例,有效率56.3%。两组有效率比较差异有显著性(P<0.01)。治疗组和对照组0.5、1.0及2.0a生存率分别为87.5%vs62.5%(χ2=4.08;P<0.05)、71.8%vs40.6%(χ2=5.14;P<0.05)及60.8%vs38.4%(χ2=3.96;P<0.05)。结论经纤支镜微波治疗和局部化疗对中央型肺癌有较高的局部疗效,该方法配合全身静脉化疗较单纯化疗可提高晚期非小细胞肺癌的生存率。

[Objective] To observe the treatment efficiency of the patients with advanced central type lung cancer by microwave and local chemotherapy using fibrobronchoseopy, combined with intravenous chemotherapy.[Methods] 64 patients with advanced non-small cell lung cancer （NSCLC） was divided into the treating group （32 patients） and the contrast group （32 patients） randomly. The treating group were treated with microwave and injection of MMC 12 mg into the rest of tumor by fibrobronchoscopy, combined intravenous chemotherapy with the routine MVP regimen, while the contrast group with intravenous chemotherapy with the routine MVP regimen. [Results] Complete remission （CR） 12, partial remission （PR） 17, stable disease （SD） 2, progression disease （PD） 1 in the treating group and CR 3, PR 15, SD 10, PD 4 in the contrast group , were observed respectively. The efficiency rate （CR＋PR） was significantly higher than that of the contrast group（90.6% vs 56.3%; P 〈0.01 ）.The 2--year survival rate was significantly higher than that of the contrast group （60.8% vs 38.4%; P 〈0.05）. [Conclusions] The microwave and the local chemotherapy by fibrobronchoscopy can significantly reduce the size of tumor and improve 2 year survival rate of patients with advanced non-small cell lung cancer, combined with intravenous chemotherapy.