经支气管镜高频电刀治疗伴大气道阻塞的晚期中央型肺鳞癌的临床研究

Endobronchial Electrocautery Treatment of Tracheobronchial Obstructive Lesions in Inoperable Tracheobronchial Squamous Cell Carcinoma

目的探讨经支气管镜高频电刀治疗伴大气道阻塞的晚期中央型肺鳞癌的有效性和安全性。方法选择2002年1月至2007年3月在长征医院治疗的95例晚期中央型肺鳞癌患者。其中34例伴大气道阻塞的患者行高频电刀联合化疗(A组),61例不伴大气道阻塞的患者行化疗(B组)。化疗方案包括顺铂或卡铂联合一个第三代化疗制剂。结果高频电刀治疗后,A组患者FEV1和呼气峰流速(PEF)分别较术前提高41.1%和65.6%。A、B两组中位生存时间分别为11.3个月和11.6个月,两组3个月、6个月和12个月生存率分别为87%、68%、39%和93%、76%、45%。两组患者的生存率无明显差异。结论对于伴大气道阻塞的晚期肺鳞癌患者行高频电刀术是一种安全、有效的方法。

Obstractive To observe the clinical effects and safety of endobronchial electrocautery treatment for tracheobronchial obstructive lesions in inoperable tracheobronchial squamous cell carcinoma. Methods Ninety-five patients with advanced and inoperable tracheobronchial squamous cell carcinoma were included. Thirty-four patients with central airway obstruction were treated with endobronchial electrocautery plus chemotherapy （group A ） and 61 patients without central airway obstruction were treated with chemotherapy alone （ group B）. The chemotherapy consisted of cisplatin or carboplatin, plus another thirdgeneration chemotherapy agent. Results In groug A,there were mean improvements in FEV1of 41. 1% and in peak expiratory flow（PEF） of 65.6%. There was no significant difference in the survival rates of the patients with and without central airway obstruction. Median survival time of group A was 11.3 months and those of group B was 11.6 months. 3,6,and 12-month survival rates in group A were 87% ,68% and 39% respectively,and those in group B were 93% ,76%, and 45% respectively. Conclusion Endobronchial electrocautery is an effective and safe approach for inoperable tracheobronchial obstructive malignancies with few complications.