微导管介入化疗治疗肺癌小脑转移瘤的近期疗效观察

Short-term efficacy of microcatheter interventional chemotherapy in cerebellar metastasis of lung cancer

目的探讨微导管介入化疗治疗肺癌小脑转移瘤患者的近期疗效。方法选取17例肺腺癌小脑单发转移患者采用微导管技术进行动脉内介入化疗(替尼泊苷、卡莫司汀、卡铂和吡柔比星等个体化联合化疗),每4周进行1次,连续治疗2次,4周后复查头部增强MRI并根据实体瘤疗效评价标准进行近期疗效评价。17例患者均完成2次介入治疗,每次结束后均评价患者的化疗药物不良反应和脑血管并发症发生情况,共记录34例次。结果17例患者中,完全缓解4例(23.5%),部分缓解5例(29.4%),疾病稳定7例(41.2%),疾病进展1例(5.9%)。颅内病灶治疗有效率为52.9%(9/17),疾病控制率为94.1%(16/17)。药物不良反应发生率为11.8%(4/34),无≥3级不良反应发生,脑血管并发症发生率为8.8%(3/34),经治疗后无明显后遗症。结论采用微导管技术进行的颅内小脑转移瘤介入化疗具有可靠的近期疗效,不良反应轻微且可控,是颅内转移瘤治疗可供选择的有效方法之一。

Objective To evaluate the short-term efficacy of microcatheter interventional chemotherapy for patients with cerebellar metastasis of lung cancer.Methods Seventeen patients with single cerebellum metastasis of lung adenocarcinoma received intracranial arterial infusion chemotherapy using microcatheter technique,and teniposide,carmustine,carboplatin and pirarubicin were given individualizely.This procedure was performed once every 4 weeks for 8 weeks in succession.Follow-up brain enhanced MRI was regularly performed at intervals of 4 weeks after the treatment.All patients received 2 intervention therapeutic cycles.The adverse effects and cerebrovascular complications were evaluated after each therapeutic cycles(n=34).Results Among 17 cases,complete response(CR)was obtained in 4(23.5%),partial response(PR)was obtained in 5(29.4%),stable disease(SD)in 7(41.2%),and progressive disease(PD)in one(5.9%),with an effective rate of 52.9%(9/17)and clinical benefit rate of 94.1%(16/17).The incidence of adverse effects was 11.8%(4/34),and there were no≥grade 3 adverse events.The rate of cerebrovascular complications was 8.8%(3/34),and there were no significant sequelae after treatment.Conclusion Interventional chemotherapy with microcatheter technique may have satisfactory short-term efficacy for cerebellar metastasis of lung cancer,with minor and controllable adverse reactions.