支气管动脉灌注化疗与栓塞在Ⅲ期非小细胞肺癌治疗中的价值

Clinnical efficacy of bronchial arterial infusion chemotherapy and embolization in the treatment of stage Ⅲ non-small cell lung cancer

目的评估支气管动脉灌注化疗及栓塞在Ⅲ期非小细胞肺癌治疗中效果。方法将120例Ⅲ期非小细胞肺癌患者随机分为观察组及对照组各60例。观察组行支气管动脉灌注化疗及碘化油栓塞4周期,4周期结束后用明胶海绵将支气管动脉完全栓塞;对照组行常规支气管动脉灌注化疗4周期。对比其疗效及不良反应,评估支气管动脉灌注化疗及栓塞的临床应用价值。结果观察组与对照组完全缓解+部分缓解分别为41例(68.3%)和32例(53.3%),无进展生存期分别为(9.8±1.6)个月和(5.1±0.8)个月,中位生存期分别为(17.5±2.2)个月和(11.8±1.5)个月,3项指标差异均有统计学意义(P<0.05);观察组与对照组1、2、3、5年生存率分别为70.7%、47.4%、13.6%、8.8%和59.7%、32.4%、14.6%、9.5%,其中1、2年生存率差异有统计学意义(P<0.05),3、5年生存率差异无统计学意义(P>0.05);观察组与对照组总不良反应率分别为35.6%和33.9%,其差异无统计学意义(P>0.05)。结论支气管动脉灌注化疗及栓塞对Ⅲ期非小细胞肺癌近期疗效明显优于单纯支气管动脉灌注,且不良反应无增加,值得临床推广。

Objective To evaluate the curative effect of the bronchial arterial infusion chemotherapy and embolization in stage Ⅲ non-small cell lung cancer.Methods One hundred and twenty cases of stage Ⅲ non-small cell lung cancer were randomly divided into observation group and control group.The observation group was given 4cycles bronchial arterial infusion chemotherapy and embolization of iodized oil,then the bronchial artery was embolismed with gelfoam completely at the end of the fourth cycle.The control group was given routine bronchial arterial infusion chemotherapy.Then it was compared of two groups that the curative effect,side effects,and assess the clinical value of bronchial artery perfusion chemotherapy embolism.Results The complete remission（CR）and partial remission（PR）in the observation group and control group were 41cases（68.3%）and 32cases（53.3%）respectively.Progression free survial of patients in the obvervation group were（9.8±1.6）months and（5.1±0.8）months,the median survival were（17.5±2.2）months and（11.8±1.5）months respectively,three indicators have statistical significance（P〈0.05）.Observation group 1,2,3,5years survival rate（%）70.7,47.4,13.6,8.8,and control group in 59.7,32.4,14.6,9.5;There was significant difference for1,2year survival rate（P〈0.05）,and no statistical significance for 3,5year survival rate（P〈0.05）;Total adverse reaction rate was 35.6%,35.6%,with no statistical significance P〈0.05.Conclusion Bronchial arterial infusion chemotherapy and embolization for stageⅢ non-small cell lung cancer in the near future curative effect is superior to pure bronchial arterial infusion,and without increase of side effects.This method is worthy of clinical promotion.