支气管动脉化疗栓塞术治疗老年晚期肺癌患者的安全性及临床疗效

Safety and clinical efficacy of bronchial arterial chemoembolization in elderly patients with advanced lung cancer

目的:探讨支气管动脉化疗栓塞术治疗老年晚期肺癌患者的安全性、有效性及对患者生存质量的影响。方法:共计32例年龄≥70岁的晚期肺癌患者,经多学科会诊认为不能耐受放化疗而接受介入治疗的患者。统计学方法比较介入手术前后患者肺功能、PS分值及肿瘤标志物水平,术后4~6周增强CT评价介入治疗效果,所有患者均随访至死亡。结果:介入手术技术成功率为100%,临床有效率为65.6%,介入术后PS评分较术前好转(P=0.00);肺功能检查FEV1及MVV介入术后较术前提高(P<0.05)。介入术后TAM、CEA、CA125及Cyraf21-1水平较术前下降(P<0.05)。介入术后56.3%的患者接受放化疗治疗,6、12个月生存率分别为93.6%、58.9%。结论:70岁以上老年肺癌患者接受支气管动脉灌注化疗栓塞术是安全可行的,介入手术可有效控制肺癌的局部进展,并提高患者的肺功能及生存质量,为患者序贯接受其他治疗创造条件。

Objective:To investigate the safety and efficacy of bronchial artery chemoembolization(BACE) in the treatment of elderly patients with advanced lung cancer,and to evaluate the effect of the BACE on patients’ quality of life.Methods:A total of 32 patients with advanced lung cancer aged more than 70 years who received BACE were collected.All patients can not tolerate radiotherapy and chemotherapy according to multidisciplinary consultation.The PS score,tumor markers level and pulmonary function before and after BACE were compared by statistical method.The effect of interventional therapy was evaluated by enhanced CT 4 weeks after BACE.All patients were followed up to death.Results:The success rate of BACE technique was 100%.The clinical effective rate was 65.6%.PS score after BACE was better than that before operation(P=0.00).Pulmonary function index FEV1 and MVV were significantly improved after BACE(P<0.05).The tumor markers TAM,CEA,CA125 and Cyraf21-1 after BACE were lower than those before intervention(P<0.05).56.3% of the patients underwent systemic intravenous chemotherapy after BACE.The 6 and 12 months survival rate was 93.6% and 58.9% respectively.Conclusion:BACE was safe and feasible for the elderly patients over seventy years old.Interventional operation could control the local progression of lung cancer and improve the quality of life of the patients,and create conditions for patients to receive other treatment sequentially.