支气管动脉化疗栓塞结合同步放疗、静脉化疗治疗中心型肺癌

Transbronchial arterial chemoembolization combined with radiotherapy and intravenous chemotherapy for central type carcinomas of lung

目的探讨支气管动脉化疗栓塞结合同步放疗、静脉化疗治疗中心型肺癌的疗效。方法178例中晚期中心型肺癌患者采用支气管动脉化疗栓塞,第2天行放疗。放疗总剂量60～70 Gy,6～7周完成。3～4周后采用长春瑞滨、顺铂或伊托铂苷、顺铂方案,共化疗2个周期。结果患者临床症状均有明显好转。CR 39.89%,PR 46.06%,有效率(CR+PR)85.95%,中位生存期为23.4个月,1、2、3年生存率分别为79.7%、45.3%、24.5%。无严重并发症发生。结论经支气管动脉化疗栓塞结合放疗、静脉化疗治疗中心型肺癌能延长患者的中位生存期,提高患者的生存率,具有较好的临床疗效。

Objective To evaluate the therapeutic effect of transbronchial arterial ehemoembolization together with synchronous radiotherapy and intravenous chemotherapy in treating central type carcinomas of lung. Methods A total of 178 eases with mid-stage or advanced central type carcinoma of lung were enrolled in this study. In all patients transbronehial arterial chemoembolization was performed, which was followed by radiotherapy. The radiotherapy was accomplished within 6 - 7 weeks with the total accumulated dose of 60 - 70Gy. Three to four weeks later, two cycles of systemic chemotherapy by using NP scheme or EP scheme were carried out. The clinical results were analyzed. Results After the treatment, the clinical symptoms were markedly improved in all patients. The complete remission rate （CR） and partial remission rate （PR） was 39.8% and 46.06%, respectively, with an overall response rate （CR ＋ PR） of 85.95%. The median survival period was 23.4 months, and the 1-year, 2-year and 3-year survival rates were 79.7%, 45.3% and 24.5%, respectively. No severe complications occurred. Conclusion Transbronchial arterial chemoembolization combined with radiotherapy and systemic chemotherapy is an effective treatment for the central type carcinomas of lung. This therapy can distinctly elongate the median survival period and increase the survival rate.（J Intervent Radiol, 2012, 21： 297-300）