放疗合并介入治疗癌性上腔静脉综合征

Combined therapy of interventional chemotherapy and radiotherapy in the treatment of carcinous superior caval syndrome

目的探讨由恶性肿瘤所致的上腔静脉压迫综合征的治疗方法。方法采用６０Ｃｏ照射，前后对穿放疗，总剂量为６０～７０Ｇｙ，介入法采用经皮穿刺肿瘤供血动脉插管化疗药物灌注，每次灌注表阿霉素３０ｍｇ＋卡铂３００ｍｇ＋西艾克（长春地辛）４ｍｇ或羟基喜树碱６ｍｇ，介入治疗与放疗交替进行。结果２８例病人ＣＲ２３例，ＰＲ４例，总有效率（ＣＲ＋ＰＲ）为９６．４％（２７／２８），平均缓解期为１４．５个月。结论采用介入化疗与放疗相结合，可使造成上腔静脉综合征的瘤体迅速缩小，受压症状消失快，与以往单独放疗或单独静脉化疗相比，疗效高，缓解期长，不失为上腔静脉综合征临床选用的治疗手段。

Objective To observe the therapeutic effect of combined therapy of interventional chemotherapy and radiotherapy in the treatment of superior caval syndrom caused by malignant tumours.Methods 28 cases of superior caval syndrome caused by oncothlipisis were given radiotherapy of D T 60～70 Gy (with 60 Co). Interventional chemotherapy was given percutaneous artery (supplying tumour) catherized into chemotherapy drugs:pharmorubincin 30mg,carboplatin 300mg and VDS 4mg (or 10-hydroxy camptothecici 6mg). Interventional chemotherapy and radiotherapy were alternating.Results The effective rate was 96.4%(27/28)(CR 23 and PR 4), the average remission span was 14.5 months.Conclusion Combined therapy of interventional chemotherapy and radiotherapy can reduce tumour(causing superior caval syndrome),alleviate pressure symptom quickly. So it has higher therapeutic effect and longer remission time than radiotherapy or interventional chemotherapy alone. It was an effective treatment method to superior caval Syndrome.