植入式药盒系统在治疗中晚期恶性肿瘤中的应用

APPLICATION OF PCS TECHNIQUETREATING LATE MALTGNANT TUMORS

目的 :探讨经皮动脉导管药盒系统 (PCS)对晚期恶性肿瘤进行介入治疗的安全性、临床疗效、并发症及处理方法。方法 :经PCS化疗灌注治疗 14例晚期恶性肿瘤 (原发性肝癌 5例 ,肝转移癌 3例 ,肺癌 5例 ,胃癌 1例 )。药盒植入途径 :股动脉 11例 ,右锁骨下动脉 3例 ,右锁骨下静脉 1例。术后经药盒灌注化疗 2～ 4个疗程 ,每 3～ 6周为 1滚疗程。结果 :14例患者手术植入都获得成功 ,4例经右锁骨下动 静脉途径植入患者无气胸、血胸发生。肿瘤治疗有效率 (完全缓解CR +部分缓解PR)为 42 9%。有化疗药外渗 1例 ,本组未发生留置导管移位、导管堵塞、感染、出血等。结论 :经皮动脉植入PCS手术操作简便、安全 ,易为患者接受。PCS能长期留置 ,不影响患者日常生活 ,并可按照化疗药物的药代动力学特点对肿瘤进行化疗 。

Objective:To evaluate the safety,therapeutic effectiveness,side effects and management of PCS technique treating late malignant tumors.Method:14 patients with late malignant tumors received PCS therapy and among them,5 patients were primary liver cancer,3 metastatic cancer,5 lung cancer and 1 gastric cancer.Drugs were infused through femoral artery (10 cases),right subclavian artery (3 cases)and right subclavian vein (1 case).2～4 therapeutic courses were conducted for the patients with 3～6 weeks for each course.Results:The drug box was successfully implanted in 14 patients with 4 patients through right subclavian artery/vein and without side effects of pneumothorax and hemathorax.The effective rate(complete and part remission)was 42.9%.Drug external leakage occurred in 1 case.There was no side effect such as catheter displacement,block,infection and bleeding.Conclusion:PCS technique is safe and easy to operate and is more acceptable by patient.Long-term indwelling insede body has little influence on patients daily life and makes it possible for doctors to conduct chemotherapy according to pharmacokinetics.It is an ideal technique for late cancer patient.