热疗联合介入化疗灌注治疗中晚期非小细胞肺癌的临床对照研究

A clinical control study on transcatheter arterial infusion chemotherapy in combination with hyperthermia for mid and advanced non-small cell lung cancer

背景与目的:热疗可以直接杀伤癌细胞或诱导癌细胞凋亡,同时又可增强机体免疫力,本文研究热疗联合介入化疗灌注治疗中晚期非小细胞肺癌的临床疗效和毒副反应。方法:选取中晚期非小细胞肺癌患者40例,随机分成两组,每组20例。A组采用局部区域热疗联合介入化疗灌注治疗,B组仅行介入化疗灌注治疗。两组病例均在介入化疗灌注治疗1～2个疗程后进行临床疗效及毒副反应评价。结果:A组病例中卡氏评分提高占80%(16/20);B组病例中卡氏评分提高占50%(10/20)(P<0.05)。A组与B组病例的临床疗效分别为:CR5%,0%;PR70%,40%;SD25%,50%;PD0%,10%(P<0.05)。A、B两组6、12、18、24个月生存率分别为100%,90%;80%,65%;65%,40%;50%,25%,且毒副反应不增加。A组病例的T细胞亚群和NK细胞的活性均高于治疗前,而B组的T细胞亚群和NK细胞的活性均低于治疗前,两组间差异显著(P<0.05)。结论:热疗联合介入化疗灌注治疗中晚期非小细胞肺癌疗效优于单纯介入化疗灌注治疗,且不增加毒副作用,是中晚期肺癌可选择的一种安全有效的治疗方法。

Background and purpose：Hyperthermia could directly kill cancer cells or induce apoptosis,it has also been proved to improve immunity of patients.In this study,we evaluated the efficacy and side effects of hyperthermia combined with transcatheter arterial infusion chemotherapy in the treatment of intermediate and advanced non-small cell lung cancer（NSCLC）.Methods：Forty patients with intermediate and advanced non-small cell lung cancer were randomly divided into two groups,with 20 each.Group A was treated with transcatheter arterial infusion chemotherapy in combination with hyperthermia,Group B was treated with interventional arterial infusion chemotherapy alone.Treatment response in both groups were evaluated as well as side effects after one or two cycles.Results：As to Group A,Karnofsky score had been improved in 16 cases,accounting for 80%（16/20）;compared with 50%（10/20）in the Group B,there was significant difference（P〈0.05）.The immediate response of both groups after treatment were CR 5%,0%;PR 70%,40%;SD 25%,50%;PD 0%,10%,in group A vs.group B,respectively.There were significant differences（P〈0.05）.The survival rates of both groups for 6,12,18 and 24 months were 100%,90%;80%,65%;65%,40%;50%,25%,respectively.There was no significant difference in terms of side effects between the two groups.T lymphocytes CD3＋,CD4＋ proportion,CD4＋/CD8＋ ratio and NK cell activity increased markedly in Group A,and decreased in Group B,there were statistically different（P〈0.05）.Conclusions：The combination of transcatheter arterial infusion chemotherapy and hyperthemia in the treatment of the intermediate and advanced NSCLC is more effective and without increasing side-effect as compared to transcatheter arterial infusion chemotherapy alone.