支气管动脉灌注化疗联合胸腔灌注化疗治疗晚期中心型非小细胞肺癌的临床分析

Clinical analysis of bronchial artery infusion combined with pleural infusion chemotherapy in advanced central NSCLC

[目的]探讨经支气管动脉灌注化疗(bronchial arterial infusion,BAI)结合胸腔灌注化疗药物治疗晚期中心型非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床疗效。[方法]对52例晚期中心型NSCLC患者,分别行支气管动脉(或相关供血动脉)灌注化疗结合胸腔灌注化疗治疗,观察术后病人的肿瘤大小变化、恶性胸水消退程度、生活质量、生存时间及毒副反应等情况。[结果]52例患者中依据肿瘤大小变化判断:显效(CR+PR)33例,占63.46%;有效(CR+PR+SD)43例,占82.69%;进展9例,占17.31%。依据恶性胸水变化判断:完全缓解(CR)18例,占34.62%;缓解(CR+PR)48例,占92.31%;无效(CN)4例,占7.69%。Karnofsky评分评价生活质量显著改善为36例,占69.23%;改善为12例,占23.08%;稳定为3例,占5.77%;无效为1例,占1.92%。随访生存时间:生存2年以上1例,占1.92%;生存1～2年10例,占19.23%;生存半年～1年21例,占40.38%;生存3～6个月13例,占25.00%,生存不足3个月7例,占13.46%。应用化疗药物后毒副反应:血液学改变全部在Ⅱ度反应以内;胃肠道反应及肝肾功能损害在Ⅲ度反应以内(除仅1例肝功能在Ⅳ度反应范围)。[结论]BAI结合胸腔灌注化疗可以提高晚期中心型NSCLC患者的生存质量及临床疗效。

[Objective] To analyze the therapeutic effect of bronchial artery infusion（BAI） combined with pleural infusion chemotherapy in advanced central NSCLC.[Methods] Fifty-two patients with advanced central NSCLC were enrolled in the study.BAI and pleural infusion chemotherapy were subsequently administered.Tumor size,malignant hydrothorax retrogression degree,quality of life and side effect were analyzed retrospectively.[Results] In all 52 patients,if evaluated with tumor size after the combined treatment,excellent（CR＋PR） was in 33 cases（63.46%）,the overall response rate（CR＋PR＋SD） occurred in 43 cases（82.69%） and progress was presented in 9 cases（17.31%）.According to judgment of the malignant pleural fluid,post-treatment CR was in 18 cases（34.62%）,CR＋PR was seen in 48 cases（92.31%） and CN was found in 4 cases（7.69%）.If evaluated with the quality of life by the Karnofsky score,significant improvement was in 36 cases（69.23%）,improvement occured in 12 cases（23.08%）,stability was seen in 3 cases（5.77%） and not valid was in 1 case（1.92%）.Two-year survival was in 1 case（1.92%）,1 to 2 year survival was showed in 10 cases（19.23%）,half-year survival in 21 cases（40.38%）,3-6 month survival was in 13 cases（25.00%）,less than 3 month survival was in 7 cases（13.46%）.The side effect of the combined treatment included hematological changes at the second degree and gastrointestinal,liver and kidney function damages at the third degree,and the fifth degree of liver function damage in just 1 case.[Conclusion] BAI combined with pleural infusion chemotherapy is a valuable treatment for the patients with advanced central NSCLC,which can improve the clinical effect and the survival quality.