经纤维支气管镜行非小细胞肺癌局部化疗临床研究

Bronchofiberscope in the treatment of advanced non-small-cell lung cancer

目的 观察经纤维支气管镜 (纤支镜 )行瘤体内局部注射抗癌化疗药物结合全身化疗 ,与单纯全身化疗治疗中晚期非小细胞肺癌的疗效。方法 选择 6 6例中晚期非小细胞肺癌 ,随机分为观察组 34例 ;经纤支镜直视下对支气管腔内瘤体局部注射化疗药物 ,同期全身化疗 ;对照组 32例 ;单用全身化疗 (方案同观察组 )。一疗程结束后评价两组疗效 ,化疗期间记录毒副反应。结果 以X线标准评价 :观察组有效率 (CR +PR)为 36 .36 % ,对照组有效率 (CR +PR)为 31.2 5 %。两组间疗效未见差异性 (P >0 .0 5 ) ;以纤支镜标准评价 :观察组有效率 (CR +PR)为 71.88% ,对照组有效率 (CR +PR)为 4 3.33%。组间疗效比较有统计学意义(P <0 .0 5 )。观察组支气管腔内瘤体缩小较对照组明显。结论 经纤支镜行肿瘤局部注射抗癌药物加全身化疗在解除支气管阻塞方面效果明显 ,毒副反应未见明显增加 ,是治疗晚期肺癌有效的姑息方法之一。

Objective:To evaluate the clinical efficacy of local chemotherapy(Infusion antitumor drugs to tumor in bronchi for relieving air-way obstruction) in the treatment of advanced non-small-cell lung cancer(NSCLC).Methods:Sixty-six patients were randomly divided into two groups: the treatment group were given the bronchofiberscope guided intratumour Cisplatin plus Mytomycin injection combined with traditional systemic chemotherapy,and the control group received traditional systemic chemotherapy only. The clinical response and the toxic-side reactions were observed.Results:Assess by Bronchofiberscope ,71.88% of patients in the treatment group showed favorable effects after the treatment,compared with 43.33% in the control group. The response rate of clinical efficacy and the main toxicity of the treatment group was similar to the control group .Conclusions:Result showed that the local chemotherapy combined with traditional systemic chemotherapy for relieving air-way obstruction was effective and safe in the treatment of advanced non-small cell lung cancer.