支气管动脉碘化油化疗栓塞肺癌

Bronchial arterial chemoembolization with ADM-Lipiodol mixture in the treatment of brochogenic carcinoma

目的探讨支气管动脉碘化油化疗栓塞治疗肺癌的可行性和疗效。方法化疗栓塞33例肺癌,其中鳞癌20例,腺癌8例,小细胞癌1例,未定型4例;Ⅱ期5例,ⅢA期13例,ⅢB期11例,Ⅳ期4例。行支气管动脉插管,经导管灌入CDDP 80-100 mg、MMC 10 mg后,再将ADM 30 mg和2-10 ml碘化油(平均4．65 ml)混悬剂化疗栓塞。另外3例化疗栓塞后1周手术切除肿瘤。结果化疗栓塞组CR 2例,PR 21例,S 9例,P 1例,有效率(CR+PR)69．7％。化疗栓塞后手术病理见肿瘤细胞大量坏死。未出现脊髓损伤等严重并发症。结论本法治疗肺癌近期疗效较好,在良好的支气管动脉数字减影血管造影基础上谨慎进行。

Objective To investigate the feasibility and the clinical effect of bronchial arterial chemoembolization with ADM-Lipiodol mixture in the treatment of brochogenic carcinoma. Methods Thirtythree cases of bronchogenic carcinoma undertaken bronchial arterial chemoembolization, including 20 cases of adenocarcinoma, 8 of squamous cell carcinoma, 1 of small cell carcinoma and 4 of undifferentiated carcinoma. The clinical staging consisted of 5 cases in Ⅱ, 13 in ⅢA, 11 in ⅢB and 4 in Ⅳ. Using Seldinger＇s technique and selective bronchial arterial catheterization （5 cases of super-selective catheterization）. After perfusion of 80 - 100 mg CDDP and 10 mg MMC, embolization with a mixture of 30 mg ADM and 2 - 10 mg Lipidol was performed. Another 3 cases were undergone surgery within 1 week after bronchial arterial chemoembolization. Results The 33 cases of bronchial arterial chemoembolization, showed 2 cases of complete response（CR）, 21 of partial response（PR）, 9 of stable（S） and 1 of processes（P）. The pathology revealed massive necrosis of tumor cells after bronchial arterial chemoembolization. No severe complications such as spinal injury occurred. Conclusions Bronchial arterial chemoembolization with ADM-Lipiodol mixture for the treatment of brochogenic carcinoma is good short-term effectiveness. The procedure should be carried out carefully on the basis of fine digital subtraction angiography.