静脉化疗联合干扰素和平阳霉素超声引导下瘤内注射治疗中晚期周围型肺癌

目的:观察静脉化疗联合超声引导下经皮穿刺干扰素和平阳霉素瘤内注射治疗晚期周围型肺癌的疗效。方法:静脉化疗为NP方案[长春瑞滨(NVB)25mg/m2,第1、8天;DDP40mg/日,第1～3、4天]和GP方案[吉西他滨(GEM)1000mg/m2,第1、8天;DDP40mg/日,第1～3、4天]化疗,先NP方案后GP方案,分别给予3个疗程。28天为1个周期,均用4个疗程以上。同时周围型肺癌病灶给予彩超引导下瘤体内注射α-2b干扰素600万U、平阳霉素16mg,每次化疗前后各1次。结果:35例中,CR4例,PR18例,SD13例,PD0例;RR为66.86%。肺病灶局部疗效为CR4例(11.43%),PR26例(74.29%),SD5例(14.28%),PD0例;RR为85.71%。静脉化疗主要不良反应为食欲低下,白细胞减少,其他不良反应均轻微可耐受;瘤内注射治疗的不良反应有穿刺部位轻微疼痛、发热、咳嗽和咯血;无治疗相关死亡。结论:α-2b干扰素和平阳霉素瘤内注射治疗与静脉全身化疗的结合对晚期周围型肺癌的治疗可能有较高疗效,并较为安全,患者可接受,有待进一步研究和随访。

Objective：To observe the intravenous chemotherapy combined with intratumoral injection of interferon and pingyangmycin under ultrasound-guided in treatment of the advanced peripheral lung cancer.Methods：All patients were treated with NP regimen [vinorelbine（NVP） 25mg/m2,iv gtt d1、8;cisplatin（DDP） 30mg/d,iv gtt d1～3、4] and GP regimen [gemcitabine（GEM） 1000mg/m2,iv gtt d1、8;cisplatin（DDP） 30mg/d,iv gtt d1～3、4];First the NP program after the GP program,were given 3 courses.28 days are one cycle,and each patients received more than 4 courses.Peripheral lung lesions given color doppler ultrasound-guided intratumoral injection of interferon alpha-2b 6 million units,of Pingyangmycin 16 mg,before and after each chemotherapy.Results：Among the 35 patients CR 11.43%,PR 51.43%,SD 37.14%,PD 0%,with an overall response rate（RR） of 66.86%.The local efficacy of lung lesions for the CR4 cases（11.43%）,PR26 cases（74.29%）,the SD5 cases（14.28%）,the PD 0 cases;RR was 85.71%.The main toxicities of intravenous chemotherapy were poor appetite,leukopenia,and other side effecets were mild.The side effects of intratumoral injection were the slight pain of the puncture site,fever,cough and hemoptysis.There were no any death during treatment.Conclusions：The intravenous chemotherapy combined with intratumoral injection of interferon and pingyangmycin under ultrasound-guided cancer may have has a safe and high therapeutic effect on the advanced peripheral lung cancer,pending further study and follow-up.