CalliSpheres^(®)微球支气管动脉化疗栓塞术治疗非小细胞肺癌性胸腔积液疗效观察

Drug-eluting beads bronchial artery chemoembolization treatment for non-small cell lung cancer associated with pleural effusion:observation of curative effect

目的评价CalliSpheres^(®)载药微球支气管动脉化疗栓塞术联合肋间动脉灌注化疗治疗顽固性非小细胞肺癌(NSCLC)性胸腔积液疗效及安全性。方法采用改良Seldinger技术经右侧股动脉插入动脉导管,用微导管超选插至患侧血供丰富的支气管动脉及肋间动脉,灌注化疗药物后使用CalliSpheres^(®)载药微球栓塞肿瘤供血血管17例,并与19例传统治疗方法比较。结果3个月后使用本法治疗的17例患者生活质量明显改善,治疗有效率明显高于使用传统化疗的患者,整体有效率达到了100%(疗效与传统方法比为100%比52.6%),中位疾病无进展期(mPFS)和总生存期(OS)高于使用传统化疗的患者(PFS为8.8个月比4.1个月,OS为13.4个月比7.0个月);该法不良反应轻微,所有患者均未出现严重并发症。结论该治疗方法效果明显,不良反应小,为治疗顽固性NSCLC性胸腔积液提供了一条新思路。

Objective To evaluate the efficacy and safety of drug-eluting bead s(CalliSpheres)bronchial artery chemoembolization(DEB-BACE)combined with intercostal artery infusion chemotherapy in treating non-small cell lung cancer(NSCLC)associated with refractory pleural effusion.Methods By using modified Seldinger’s technique,catheterization via right femoral artery was performed,which was followed by super-selective catheterization to insert the microcatheter into the diseased-side bronchial artery and intercostal artery that supplied abundant blood to the lesion.After infusion of hemotherapeutic drugs,the tumor-feeding arteries were embolized with drug-eluting beads(CalliSpheres).Results A total of 17 patients received DEB-BACE plus intercostal artery infusion chemotherapy,and three months after treatment their quality of life was significantly improved.The overall therapeutic effective rate was up to 100%,which was remarkably higher than 52.6%of traditional chemotherapy.The median progress-free survival(mPFS)and overall survival(OS)were 8.8 months and 13.4 months respectively,which were much higher than 4.1 months and 7.0 months respectively of traditional chemotherapy.The adverse reactions were rather mild and no serious complications occurred in all patients.Conclusion This therapeutic method has obvious effect and mild side reactions,providing a new approach for the treatment of NSCLC associated with refractory pleural effusion.(J Intervent Radiol,2021,30:713-718)