支气管镜引导下^(125)I粒子植入联合支气管动脉灌注化疗栓塞术在晚期中心型肺鳞癌中的应用效果

Application effect of bronchoscope-guided ^(125)I implantation combined with bronchial artery infusion chemoembolization in advanced central lung squamous cell carcinoma

目的探讨采取经电子支气管镜(EB)植入^(125)I粒子+支气管动脉灌注化疗栓塞术疗法在晚期中心型肺鳞癌(LUSC)中的应用效果与安全性。方法回顾性选取2017年6月至2020年2月福建医科大学附属闽东医院收治的68例Ⅲb~Ⅳ期中心型LUSC患者作为研究对象,按不同治疗方法将其分为联合治疗组(n=32)与单纯灌注化疗栓塞组(n=36)。联合治疗组患者采取经EB植入^(125)I粒子+支气管动脉灌注化疗栓塞术疗法;单纯灌注化疗栓塞组患者采取支气管动脉灌注化疗栓塞术疗法。两组患者均采用吉西他滨(GEM)+顺铂(DDP)化疗方案,于干预后l、3、5个月实施EB与CT检查,比较两组患者的疗效与不良反应。结果联合治疗组的疗效优于单纯灌注化疗栓塞组,差异有统计学意义(P<0.05)。联合治疗组的咯血发生率高于单纯灌注化疗栓塞组,差异有统计学意义(P<0.05)。两组患者的骨髓抑制、发热与气胸发生率比较,差异无统计学意义(P>0.05)。发生的各不良反应皆为轻度,在可控范围内。结论经EB植入^(125)I粒子+支气管动脉灌注化疗栓塞术可获得较好的近期疗效,其用于晚期中心型LUSC的治疗具备安全性、微创性。

Objective To evaluate the clinical effect and safety of advanced central lung squamous cell carcinoma(LUSC)with^(125)I seed implantation via electronic bronchoscope(EB)+bronchial artery infusion chemoembolization.Methods Sixty-eight patients with stageⅢb-Ⅳcentral LUSC admitted to Mindong Hospital Affiliated to Fujian Medical University from June 2017 to February 2020 were retrospectively selected as the study objects,and they were divided into combination treatment group(n=32)and chemotherapy embolization group(n=36)according to different treatment methods.Combined treatment group was treated by EB^(125)I seed implantation+bronchial artery infusion chemoembolization.Bronchial artery infusion chemoembolization was performed for patients in the single perfusion chemoembolization group.Gemcitabine(GEM)+Cisplatin(DDP)chemotherapy regimen was used in both groups,and EB and CT examinations were performed l,3 and 5 months after intervention.The efficacy and adverse reactions of the two groups were compared.Results The curative effect of combined treatment group was better than that of perfusion chemoembolization group,and the difference was statistically significant(P<0.05).The incidence of hemoptysis in the combined treatment group was higher than that in the chemotherapy embolization group,and the difference was statistically significant(P<0.05).There were no significant differences in the incidence of bone marrow suppression,fever and pneumothorax between the two groups(P>0.05).All the adverse reactions were mild and under control.Conclusion EB implantation of^(125)I seeds+bronchial artery infusion chemoembolization can obtain better short-term curative effect.So,it is safe and minimally invasive in the treatment of advanced central LUSC.