晚期非小细胞肺癌的双途径化疗

Double-pathway chemotherapy for advanced non-small-cell lung cancer

目的 :研究不同的化疗方法治疗晚期非小细胞肺癌 (NSCLC)并观察其疗效和毒副反应。方法 :将 5 5例晚期NSCLC患者分 4组 ,A组经皮肺穿刺瘤体内注射卡铂 (PCI) +支气管动脉灌注 (BAI)双途径化疗 13例 ,B组PCI+VP 16静滴 12例 ,C组单纯BAI 18例 ,D组传统静脉化疗 12例进行临床对比观察。结果 :近期有效率A组为76 .9% ,B组为 5 8%高于C组 33.3% ,明显高于D组的 16 .7% (P <0 .0 1)。一年生存率A组 6 9.2 % ,B组 75 % ,优于C组的 38.9% ,更明显优于D组 8.3% (P <0 .0 1)。一般状况的改善A、B、C三组明显优于D组 (P <0 .0 1) ;而毒副反应均明显低于D组 (P <0 .0 1)。结论 :PCI是一种安全、简便的直接介入疗法 ,联合BAI或VP 16静滴双途径化疗是晚期NSCLC较为理想有效的综合性治疗手段 ,且PCI+VP 16疗法较PCI+BAI疗法更安全、简便、费用少 ,并发症少。

Purpose:To investigate the various methods of chemotherapy in the treatment of advanced non-small-cell lung cancer (NSCLC) Methods:55 patients were allocated to 4 group:the A groups (13 patients were given the ultrasound guided percutaneous intratumor carboplatin injection(PCI) combined with bronchial artery infusion(BAI), the B group (12 patients were given PCI+VP-16intravenounaly ),the C group (18 patients) received only BAI and the D group (12 patients) received traditional systemic chemotherapy. The clinical response and the toxic-side reactions were observed.Results:The immediate effective rates were 76.9% in group A, 58% in group B,33% in group C and 16.7% in group D respectively ( P <0.01). The 1-year survival rate was 69.2% in group A , 75% in group B , 38.9% in group C ,8.3% in group D respectively( P <0.01).Conclusions:PCI is a safe and convenient direct interventional therapy .The combined PCI and BAI or intravenous infusion of VP-16 (double pathway chemotherapy) is the ideal,effective therapy for advanced NSCLC ,and the PCI+VP-16 combination is a safer, more convenient and cheaper protocol than PCI+BAI therapy.