超选择支气管动脉碘油化疗栓塞术治疗肺癌的初步研究

A Study of Superselective Bronchial ArterialI odized Oil Chemoembolization for The Treatment of Lung Cancer

[目的]探讨超选择支气管动脉碘油化疗栓塞术治疗肺癌的近期疗效和安全性。[方法]23例病理证实的肺癌患者,先行支气管动脉造影明确肿瘤血供,超选择性插管入肿瘤供血动脉行局部灌注化疗后,以抗癌药物碘油乳剂进行栓塞。术后随访3个月,主要观察临床症状和肿瘤大小的变化以及并发症。[结果]23例患者均成功行支气管动脉超选择插管和碘油化疗栓塞术。术后反应均为栓塞反应和/或化疗药物的不良反应,无肋间动脉和脊髓动脉并发症发生。术后3个月部分缓解(PR)16例、稳定6例(SD)、进展(PD)1例,总有效率为69.6%(16/23),临床受益率(CR+PR+SD)为95.6%,临床症状缓解率为87%。[结论]超选择支气管动脉碘油化疗栓塞术是肺癌安全、有效的治疗方法,严格掌握适应证是提高疗效、降低并发症的关键。

To evaluate the short-term effect and safety of superselective bronchial arterial iodized oil chemoem-bolization in the treatment of lung cancer.Twenty-three patients with lung cancer pathologically proved were studied.Bronchial arteriography was performed to identify the tumor-feeding branch for superselective catheteriza-tion with coaxial microcatheter technique in all patients.After anticancer drugs was infused,embolization with the emul-sion of anticancer drugs and lipiodol was performed.The symptoms,tumor size and complications were observed in3months.All23bronchial arteries were successfully superselectively catheterized and chemoembolized.The ma-jor toxicity of the procedure was chemotherapeutic and embolized toxicities.All the complications were recovered after appropriate management.None of complications for intercostal artery and spinal artery was found.At3months after procedure,the overall response rate(RR)was69.6%(16/23)with partial response(PR)in16cases,stable disease(SD)in6cases and progressive disease(PD)in one case.The clinical benefit rate(CR+PR+SD)was95.6%.Clinical symp-toms were relieved in87%.[Conclusion]Superselective bronchial arterial iodized oil chemoembolization is a safe and safe method for the treatment of lung cancer.Strict mastery of indication is the key to increase the short-term effect and reduce complications.