吉西他滨载药微球经支气管动脉化疗栓塞治疗中晚期不可切除肺鳞状细胞癌的临床研究

Clinical study of gemcitabine drug-eluting beads for bronchial arterial chemoem-bolization in the treatment of moderate and advanced unresectable lung squamous cell carcinoma

目的探讨吉西他滨载药微球经支气管动脉化疗栓塞治疗中晚期不可切除肺鳞状细胞癌的临床疗效与安全性。方法收集2020年10月至2022年5月马鞍山市人民医院收治的32例中晚期不可切除肺鳞状细胞癌患者的临床资料,根据治疗方案的不同将患者分为A组(n=16,采用吉西他滨+顺铂或卡铂化疗)、B组(n=8,给予支气管动脉灌注化疗,即白蛋白结合型紫杉醇200 mg+顺铂60 mg)和C组(n=8,给予支气管动脉灌注化疗,即吉西他滨600 mg+顺铂60 mg,灌注化疗后使用载药微球吉西他滨600 mg,之后静脉补充顺铂60 mg+吉西他滨800~1200 mg)。比较3组患者的治疗结局,包括客观缓解率(ORR)、疾病控制率(DCR)、临床疗效及总生存期。结果治疗后,3组患者ORR、DCR、临床疗效以及总生存期超过12个月的比例比较,差异均无统计学意义(P﹥0.05)。治疗后,部分患者发生药物相关不良反应,其中,3组患者恶心呕吐、腹泻、骨髓抑制、肝功能损伤及肾功能损伤的发生率比较,差异均无统计学意义(P﹥0.05);3组患者食欲减退和脱发的发生率比较,差异均有统计学意义(P﹤0.05)。结论吉西他滨载药微球经支气管动脉化疗栓塞治疗中晚期不可切除肺鳞状细胞癌的疗效、安全性与单纯全身化疗和支气管动脉灌注化疗相近,可以作为后两种治疗方案的替代方案。

Objective To investigate the clinical efficacy and safety of gemcitabine drug-eluting beads for bronchial artery chemoembolization in the treatment of moderate and advanced unresectable lung squamous cell carcinoma.Method The clinical data of 32 patients with moderate and advanced unresectable lung squamous cell carcinoma admitted to Maanshan People's Hospital from October 2020 to May 2022 were collected and divided into three groups according to the treatment plans:group A(n=16,received chemotherapy with gemcitabine and cisplatin or carboplatin,group B(n=8,received bronchial artery infusion chemotherapy with paclitaxel 200 mg and cisplatin 60 mg)and group C(n=8,treated with bronchial artery infusion chemotherapy of 600 mg of gemcitabine+60 mg of cisplatin,followed by loading of 600 mg of gemcitabine drug-eluting beads and intravenous supplementation of 60 mg of cisplatin+800-1200 mg of gemcitabine).The treatment outcomes including objective remission rate(ORR),disease control rate(DCR),clinical efficacy,and overall survival of three groups of patients were compared.Result After treatment,there were no statistically significant differences in the ORR,DCR,clinical efficacy,and proportion of patients with overall survival exceeding 12 months among the three groups of patients(P>0.05).After treatment,some patients experienced drug-related adverse reactions,among them,there were no statistically significant differences in the incidence of nausea,vomiting,diarrhea,bone marrow suppression,liver function damage,and kidney function damage among the three groups of patients(P>0.05);the incidence of decreased appetite and hair loss were compared among the three groups of patients,and the differences were statistically significant(P<0.05).Conclusion The efficacy and safety of gemcitabine drug-eluting beads through bronchial artery chemoembolization in the treatment of advanced unresectable squamous cell carcinoma of the lung are similar to those of simple systemic chemotherapy and bronchial artery perfusion chemotherapy,and can be used as an alternative choice.