术前支气管动脉灌注化疗治疗III_A期非小细胞肺癌的临床研究

The Effects of Preoperative Bronchial Arterial Infusion Chemotherapy for Stage III_A NSCLC

目的 总结应用术前支气管动脉灌注 (brouchialarteryintusionBAI)化疗治疗IIIA 期非小细胞肺癌 (NSCLC)的临床经验 ,探讨术前BAI化疗 +手术切除治疗IIIA 期NSCLC的临床效果。方法 采用seldinger方法行支气管动脉造影 ,选择肿瘤的供应动脉造影诊断明确后 ,注入化疗药物 ,术后 3周摄胸片复查肺部阴影变化情况 ,必要时作CT复查。 1～ 3个疗程后手术治疗 ,同期未行术前BAI化疗而直接手术治疗者作为对照组 ,观察两组患者的手术根治率及长期生存时间。结果 术前BAI化疗的总有效率 (CR +PR)为 66 8%,根治性切除率为 90 3 %,明显高于对照组 (根治率为 61 1%P <0 0 0 1)。术前BAI化疗组的 1;3 ;5年生存率分别为80 7%;48 6%;3 9 4%,而对照组分别为 65 5 %;2 6 1%;16 7%。两组差别有显著意义 (P <0 0 5 )。结论 术前BAI化疗是治疗IIIA 期NSCLC的一种有效辅助措施 ,能明显提高IIIA 期NSCLC的手术根治率 。

Objective To evaluate preoperative bronchial atery infusion(PBAI) chemotherapy combined with surgery for patients with stage III A non-small cell lung cancer(NSCLC). Methods Seldinger procedure was used to insert the tube to bronchial artery branch which supplied blood to the tumor. The chemotherapeutic drugs were infused through the tube. After 1～3 courses of PBAI chemotherapy, the patients received operation. The patients receiving surgical treatment without PBAI chemotherapy at the corresponding period were chosen as control group. The radical resection rate and survival rate of the two groups were analyzsed. Results The response rate (CR+PR) of PBAI chemotherapy was 66.8%, and radical resection rate (90.3%) in PBAI chemotherapy group was significantly higher than that in control group(61.1%,P<0.001). The patients in the PBAI chemotherapy group survived longer than those in the control group. Conclusion PBAI chemotherapy can increase the radical resection rate and improve the survival in the patients with III A NSCLC.