动静脉双途径化疗联合体外高频深部热疗在治疗局部晚期非小细胞肺癌中的临床应用研究

Arteriovenous double way chemotherapy combined with external high frequency deep hyperthermia in clinical research on the treatment of locally advanced non small cell lung cancer

目的研究并探讨动静脉双途径化疗联合体外高频深部热疗治疗局部晚期非小细胞肺癌的临床治疗效果。方法从我院2013年1月-2014年6月期间收治的不同病理类型局部晚期非小细胞肺癌患者中随机抽取40例患者为研究对象,均分为2组行化疗治疗,化疗药物方案选择吉西他滨1.0/m2 D1、D8＋顺铂75 mg/m2 D1~D3。治疗组：在第1天采用Seldinger改良法穿刺股动脉,在DSA引导下根据病变部位及肿瘤血供情况行超选择性支气管动脉内插管灌注化疗药化疗治疗,药物剂量按全身静脉化疗剂量的1/2~2/3计算,第2、3天继续静脉滴注余下的化疗药物,第8天给予吉西他滨1 000mg/m2,静脉滴入;并于第1、3、6、8天应用珠海和佳HG-2000Ⅲ型体外高频热疗机给予肿瘤部位深部热疗。对照组：使用传统方法予吉西他滨联合顺铂静脉全身化疗。以上方案均以21 d为一周期,所有患者在完成2个周期治疗后作疗效评价,胸部CT测量肿瘤大小为评价指标,并在4周后复查进行疗效确认。对比两组患者治疗有效率、疾病控制率,观察毒副反应情况及患者近、远期疗效。结果所有患者均完成2周期及以上治疗。其中治疗组治疗完成4周后完全缓解2例,部分缓解9例,病情稳定5例,总有效率达55%,总的疾病控制率达80%。明显高于对照组的35%及55%。且不良反应及事件发生率明显低于对照组。结论对于局部晚期的非小细胞肺癌患者而言,运用动静脉双途径化疗联合体外高频深部热疗的方式来对患者进行治疗不仅安全可靠,且具有较好的临床疗效,值得推广与应用。

[ Objective ] Research and explore the arteriovenous combination chemotherapy with external high- frequency deep part thermotherapy in the treatment of locally advanced non-small-cell lung carcinoma clinical treatment effectiveness. [ Methods ] To randomly selected 40 patients in the different pathological types of locally advanced non- small-cell lung carcinoma who in our hospital from January 2013 to June 2014, and divided them into two groups-line chemotherapy treatment, the chemotherapy drugs scheme is gemcitabine 1.0/m2 DI, D8 ＋ eisplatin 75 mg/m2 D1-D3. Group A： In the first day, to femoral artery puncture use the modified Seldinger method, in DSA guidance, according to the lesion and the tumor blood supply, in-line ultra-selective bronchial arterial infusion chemotherapy Chemotherapy. The dosage of the drug is 1/2-2/3 than the intravenous chemotherapy dose. The next day, the third day continue to apply the rest of the cisplatin, The Eighth day intravenous gemcitabine 1,000 mg/m2. And on the day 1,3,6,8, use the Zhuhai Hejia HG-2000 m type external high frequency thermotherapy machine give the location of tumor hyperthermia. Group B： Using traditional methods to intravenous chemotherapy of gemcitabine combined with cisplatin. The above scheme are 21 days for a cycle, Evaluation of therapeutic effect with all patients in the completion of 2 cycles. The evaluation index is by Chest CT measurement of tumor size. And review and confirm the efficacy after 4 cycles. Comparison of 2 groups of patients the treatment effectiveness, disease control rate, toxicity and efficacy observation of patients with short and long term. [ Results ] All 40 patients were completed two or more treatment cycles. Treatment group 20 cases, after the treatment is completed 4 cycles, two cases of complete response, nine cases of partial response, five cases of stable disease, the total effective rate of 55%, the overall disease control rate of 80%.significantly higher than the control group＇s 35% and 55%. And the incidence of adverse reactions and events was significantly lower than the control group. [ Conclusion ] For patients with locally advanced non-small-cell lung carcinoma, the use of arteriovenous combination chemotherapy with external high frequency deep hyperthermia in the treatment of patients is safe and reliable, and has significant clinical effect,it is worth for popularization and application in clinic.