X线引导下肺癌介入化疗23例疗效观察

Study of X-ray-guided Interventive Chemotherapy for 23 Cases with Lung Cancer

目的观察Ｘ线引导下肺癌介入化疗的疗效。方法Ｘ线引导下肺穿直接介入化疗治疗２３例晚期肺癌。非小细胞肺癌２１例，小细胞肺癌２例。Ⅲ期１７例，Ⅳ期６例。药物为吡柔比星（ＴＨＰ）４０～６０ｍｇ／ｍ２、长春新碱２ｍｇ和卡铂４００ｍｇ／ｍ２，稀释至１０～２０ｍｌ，每３周一次，三次为１疗程，共９５例次。结果完全缓解（ＣＲ）１例，部分缓解（ＰＲ）１６例，稳定（ＮＣ）４例，恶化（ＰＤ）２例。８例咯血治疗后，６例消失，２例减轻为痰血。６例胸痛治疗后，３例完全消失，１例明显好转，２例无变化。６例阻塞性肺不张治疗后，２例肺复张，１例明显好转，３例无变化。影像学改变：肿块缩小，密度增加或伴空洞形成。组织学变化：肿瘤组织液化坏死，癌细胞变性，不同程度纤维化增生。毒副反应及并发症轻，无严重不良反应。结论本法全身毒副反应轻，抗肿瘤效果显著，症状缓解率高。

Objectives To study the result of X-ray-guided interventive chemotherapy for Lung cancer. Methods 23 patients including non small cell lung cancer (NSCLC) 21 cases and small cell Iung cancer (SCLC) 2 cases had stage 17 cases and stage 6 cases. The method was X-ray-guided interventive chemotherapy of lung cancer with pirarubicin (THP) (40-60mg/m2), vincristine (VCR) (2mg) and carboplatin (CARB) (400mg/m2) (diluted to 10-20ml with 2% lidocaine) once time every three weeks. Three times was one course of treatment. Results 23 patients had 1 case complete response (CR), 16 cases partial response (PR), 4 cases no change (NC) and 2 cases progressive diseases (PD). After treatment, 8 cases hemoptysis had 6 cases CR and 2 cases PR, 6 cases with chest pain had 3 cases CR, 1 case PR and 2 cases NC, 6 cases obstructive atelectasis had 2 cases CR, 1 case PR and 3 cases NC. X-ray showed tumor lessen, internal thicken or cavity form. In pathology, there were cancerous tissue necrosis, vascular obtiteration, deSide effect and complications were not seriors. Conclusions It suggests that X-ray- guided interventive chemotherapy for lung cancer is rather a safe and effective palliative therapy for the unresectable lung cancer.