Clinical study of interventional preoperative bronchial artery infusion chemotherapy combined with surgical resection for advanced non-small cell lung cancer

Objective： How to improve the postoperative 5-year survival rate for lung cancer and to give more patients a chance of surgery have become research hotspots. The aim of this research is to evaluate the clinical and pathohistological responses and effects of preoperative bronchial artery infusion （BAI） chemotherapy in patients with locally advanced （stage Ⅲ） non-small cell lung cancer （NSCLC）. Methods： A total of 92 patients with locally advanced NSCLC were randomly divided into two groups. BAI group received BAI chemotherapy for 2 cycles before surgical resection. Surgery group received operation only. The complete resection rate and clinical response were compared between the two groups. Results： In the BAI group, the clinical response rate and the pathohistological response rate were 68.3% and 51.3%, respectively. The complete resection rate in the BAI group was 89.7%, which was significantly higher than that in the surgery group （72.5%） （P 〈 0.05）. The 1- and 2-year survival rate was 100.0% and 80.6% in the BAI group, and 94.1% and 60.0% in the surgery group. Conclusion： BAI neoadjuvant chemotherapy is safe and effective, which has a good clinical and pathohistological response. It might increase the complete resection rate of the tumor and improve the long term survival rate of stage Ⅲ NSCLC patients.

Effect of bronchial arterial infusion chemotherapy combined with elemene on the malignant lesion molecules and systemic immune response in patients with advanced lung cancer

Objective:To study the effect of bronchial arterial infusion chemotherapy combined with elemene on the malignant lesion molecules and systemic immune response in patients with advanced lung cancer.Methods:A total of 78 patients diagnosed with advanced lung cancer in our hospital between April 2013 and March 2016 were selected as research subjects and randomly divided into observation group who accepted bronchial arterial infusion chemotherapy combined with elemene therapy and control group who accepted bronchial arterial infusion chemotherapy. After 4 weeks of treatment, tumor lesions were collected to determine the expression of proliferation and invasion molecule, and serum was collected to determine the levels of immune cell-related cytokines.Results:After 4 weeks of treatment, TCF3, Livin, Bcl-2, HOXB7, PTTG1, Vimentin, E-cadherin, Rap2a andβ-catenin protein expression in tumor lesions of observation group were significantly lower than those of control group;serum IFN-γ level of observation group was significantly higher than that of control group while IL-4, IL-9, IL-10 and TGF-β levels were significantly lower than those of control group.Conclusions:Bronchial arterial infusion chemotherapy combined with elemene can inhibit the expression of proliferation and invasion of molecules in tumor lesions and improve the systemic anti-tumor immune response in patients with advanced lung cancer.

The effects on surgery and preoperative patients with non-small cell lung cancer by preoperative bronchial artery infusion chemotherapy

Objective： To study the efficiency, safety and feasibility of preoperative bronchial artery infusion （BAI） chemotherapy on operation in patients with locally advanced （stage Ⅲ） non-small cell lung cancer （NSCLC）. Methods： 92 cases with locally advanced NSCLC patients were randomly divided into two groups： （1） BAI chemotherapy group： 39 cases were received BAI chemotherapy for 2 courses and followed surgery; （2） surgery alone group： 51 cases were treated by operation alone. The complete resection rate and preoperative complications were compared between these two groups. Results： In BAI chemotherapy group, the rate of clinical efficiency was 68.3% with slight toxicity. In BAI chemotherapy group the surgery complete resection rate was 89.7%, which was significantly higher than that in surgery alone group （72.5%, P 〈 0.05）. No significant differences of blood loss, operative complications and mortality were observed between these two groups. Conclusion： BAI neoadjuvant chemotherapy was safe and effective, which can increase the complete resection rate of the tumor and did not increase the operative complications and mortality.

Effect of preoperative bronchial artery infusion chemotherapy on the tumor malignancy of patients with stage IIIA non-small cell lung cancer

Objective:To investigate the effect of preoperative bronchial artery infusion chemotherapy on the tumor malignancy of patients with stage IIIA non-small cell lung cancer.Methods:99 patients with stage IIIA non-small cell lung cancer who underwent surgical treatment in our hospital between January 2015 and August 2018 were chosen as the research subjects, and the preoperative adjuvant therapies were reviewed and used to divide them into the control group (n=51) who received conventional neoadjuvant chemotherapy and the study group (n=48) who received neoadjuvant chemotherapy combined with bronchial artery infusion chemotherapy. The differences in the expression levels of NSCLC-related proliferation, invasion and apoptosis genes in intraoperative lesion tissues were compared between the two groups.Results: NSCLC-related proliferation genes CD137L, dlk1, EZH2 and WT1 mRNA expression in lesion tissues of study group were lower than those of control group whereas DCLAK11 mRNA expression was higher than that of control group;NSCLC-related invasion genes ALX1, periostin and RAC1 mRNA expression were lower than those of control group whereas DAL-1 mRNA expression was higher than that of control group;NSCLC-related apoptosis genes Survivin, Livin, bcl-2 and Bag-1 mRNA expression were lower than those of control group.Conclusion: Preoperative bronchial artery infusion chemotherapy can further inhibit the malignant biological behaviors of cancer cells in patients with stage IIIA NSCLC.

Achievable complete remission of advanced non-small-cell lung cancer: Case report and review of the literature

Surgery is the first choice of treatment for patients with non-small-cell lung cancer(NSCLC), but few patients can be treated surgically because of either advanced disease or poor pulmonary function. Other therapies include radiotherapy and chemotherapy, as well as complementary and alternative therapies, usually with disappointing results. Bronchial artery infusion(BAI) is a manageable and effective method for treating advanced NSCLC. Outcome is good by BAI due to its repeatability and low toxicity. Icotinib hydrochloride is a newly developed and highly specific epidermal growth factor receptor(EGFR) tyrosine kinase inhibitor and has been safely and efficiently used to treat advanced NSCLC. We herein report a 73-year-old patient with chronic cough, who was diagnosed with advanced NSCLC with the EGFR mutation of L858 R substitution in exon 21, and treated with the combination of oral icotinib and BAI chemotherapy as the first-line therapy, which resulted in a satisfactory clinical outcome. Complete remission of advanced NSCLC can be achieved using the combination of oral icotinib and BAI chemotherapy.

支气管动脉灌注化疗联合栓塞术治疗PS评分≥2分晚期NSCLC患者的临床效果

目的观察支气管动脉灌注化疗联合栓塞术治疗体力状况评分(PS评分)≥2分晚期非小细胞肺癌(NSCLC)患者的临床效果。方法选取2020年11月—2022年11月景德镇市第二人民医院收治的PS评分≥2分晚期NSCLC患者60例为研究对象,采用抽签法分为对照组和试验组,各30例。对照组患者接受全身静脉化疗;试验组患者接受支气管动脉灌注化疗联合栓塞术,化疗药物与对照组一致,2组21 d为1个化疗周期,持续治疗3个周期。比较2组近期疗效,治疗后症状/体征评分、PS评分、动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、第1秒用力呼气容积与用力肺活量比值(FEV_(1)/FVC)及用药不良反应。结果试验组疾病控制率(96.67%)高于对照组(73.33%)(χ^(2)=4.706,P=0.030)。治疗3个周期后,试验组咳嗽、咯痰、咯血、胸痛、阻塞性肺炎、阻塞性肺不张评分高于对照组(P<0.01);试验组PS评分为(1.08±0.42)分,低于对照组的(2.17±0.33)分(t=11.177,P<0.001);2组PaCO_(2)低于治疗前,PaO_(2)、FEV_(1)/FVC高于治疗前,且试验组降低/升高幅度大于对照组(P<0.05或P<0.01)。试验组腹泻、恶心呕吐、骨髓抑制发生率低于对照组(P<0.05)。结论支气管动脉灌注化疗联合栓塞术治疗PS评分≥2分晚期NSCLC可有效控制疾病进展,显著改善患者的临床症状及体征,改善血气及肺功能,降低不良反应发生风险,安全性较高。

支气管动脉灌注化疗加体外照射治疗晚期肺癌37例

１９９０年２月至１９９３年１２月，选择性支气管动脉灌注化疗（ＢＡＩ）加体外放射治疗（ＲＴ）３７例不能手术的晚期肺癌（Ⅲ期３３例，Ⅳ期４例），经治疗９０．１％的病例症状消失或减轻，近期有效率（ＣＲ＋ＰＲ）：单用ＢＡＩ疗法为７０．３％，ＢＡＩ＋ＲＴ为８９．２％。随访至１９９４年５月，生存１２例，生存期４～４８个月，死亡２５例，其中位生存期１２个月，平均１４．４个月。全组病例０．５、１、２、３年生存率分别为９４．４％、６１．３％、３７．５％及６．３％。对不能手术的晚期肺癌，ＢＡＩ合并放疗是一种选择的治疗方法。

中心型非小细胞肺癌术前支气管动脉灌注化疗疗效分析

目的 评价非小细胞肺癌 (NSCLC)术前支气管动脉灌注化疗 (BAI)近期疗效。方法 经影像学判断手术切除难度较大 ,或不能手术切除的中心型NSCLC患者 2 0例行前瞻性术前BAI。BAI后行手术切除。结果 BAI治疗前后TNM分类改变 5例 ,其中N下降 1例 ,5例均有T改变 ;临床分期下降 2例。PR 8例 ,缓解率为 40 % ,其中鳞癌 6例 ,腺癌 2例 ;NC 12例 ,其中腺癌 1例 ,其余为鳞癌。BAI前后肺不张改善的 9/ 12例 ( 75 % ) ;与周围组织关系密切或受侵改善的 6 / 15例 ( 37 5 % ) ;纵隔淋巴结肿大缩小的 12 / 18例 ( 6 6 6 7% )。结论 BAI作为NSCLC ,尤其是鳞癌的术前辅助治疗 ,具有一定的近期疗效 ,与其它辅助治疗具有同样重要的临床意义 ,是一种特殊的NSCLC新辅助化疗形式。BAI后CT扫描尚不能完全反应残存肿瘤及肿瘤坏死、纤维化等组织学方面的改变 ,具有局限性。CYFRA2 1

肢体循环阻断在肺癌支气管动脉局部强化治疗的临床应用(附70例报告)

肺癌70例,均经支气管动脉内灌注地塞米松10mg,阿霉素30～60mg,丝裂霉素10～20mg,顺铂30～60mg;注药时,另外三个肢体加压,阻断循环。注药后2～4周复查,总有效率为92.8％。仅10％的病例白细胞下降低于4.0×10~9/L。此法可望提高疗效。

支气管动脉内灌注药物治疗老年肺癌疗效及影响因素分析

目的 探讨支气管动脉内灌注化疗药物 (BAI)治疗老年肺癌的疗效及影响疗效的因素。方法 采用 Seldinger法经皮股动脉穿刺插管行选择性支气管动脉造影 ,找到靶动脉后按 3种药物配合分别注入化疗药物 ,观察疗效及影响疗效的因素。结果 1本组1 0 1例老年肺癌总有效率为 90 .1 0 % ,中心型肺癌的有效率为 81 .80 % ,周围型肺癌为 65.71 %。 2有肺外淋巴结转移者有效率为70 .2 1 % ,无转移者为 61 .1 1 %。 3不同化疗药物配合对疗效的影响分别为 56.0 9% ,44.1 4 % ,52 .88%。 4肿瘤供血有侧支循环形成者疗效为 85.70 % ,无侧支循环者为 65.30 %。 5肿瘤内新生血管的影响 ,少血管型为 45.81 % ,中血管型为 65.63% ,多血管型为 75.56%。结论 选择性支气管动脉内注入化疗药物治疗老年肺癌的疗效优于静脉滴注化疗 ;其疗效与癌肿发生部位、组织类型及癌肿供血等因素有关 。

支气管动脉灌注联合全身化疗治疗晚期非小细胞肺癌

目的观察选择性支气管动脉灌注吉西他滨、奥沙利铂（GEMOX方案）并联合吉西他滨静脉滴注化疗治疗晚期非小细胞肺癌（NSCLC）的疗效和不良反应。方法对38例晚期NSCLC患者第1 d经支气管动脉注入吉西他滨、奥沙利铂,第8 d予吉西他滨静脉滴注化疗,21~28 d为一个周期,完成2~3周期后评价其疗效及不良反应。结果 38例中完全缓解（CR）0例,部分缓解（PR）23例,总有效率60.5%。主要不良反应为骨髓抑制、消化道反应等,不良反应多为Ⅰ~Ⅱ度。结论基于GE-MOX方案的支气管动脉灌注联合全身化疗治疗晚期非小细胞肺癌疗效好、不良反应可耐受。

多靶动脉减量灌注化疗联合^(125)I放射性粒子植入治疗ⅢB期非小细胞肺癌的临床意义

目的比较研究^(125)I放射性粒子植入联合多靶动脉减量灌注化疗治疗ⅢB期非小细胞肺癌(NSCLC)与联合静脉化疗临床疗效的差异。方法选取在2013年7月至2018年12月接受局部^(125)I放射性植入治疗联合化疗的ⅢB期NSCLC患者作为研究对象,收集患者各项临床特征资料,包括性别、年龄、体力状况、吸烟指数、病理类型、化疗方式、肿瘤体积(gross tumor volume,GTV)和100%靶区所受剂量(D100)等,接受动脉灌注化疗的患者为MAC组,接受静脉化疗的患者为SVC组。随访并行短期疗效评价和记录生存时间。结果57例SVC组CR、PR、SD和PR患者分别为1.8%(1/57)、47.4%(27/57)、45.6%(26/57)和5.3%(3/57),OR为49.1%;19例MAC组患者CR、PR、SD和PR分别为15.8%(3/19)、52.6%(10/19)、21.1%(4/19)和10.5%(2/19),OR为68.4%;两组差异有统计学意义(χ^(2)=8.192,P=0.042)。SVC组患者1、2和3年生存率分别为73.7%、26.3%和8.8%,mOS为16.3个月;MAC组患者1、2和3年生存率为84.2%、42.1%和15.8%,mOS为20.0个月;两组差异有统计学意义(χ^(2)=3.916,P=0.048)。亚组分析显示单一支气管动脉供血的患者mOS为25.0个月,多靶动脉供血患者mOS为16.8个月,两组患者OS差异明显(χ^(2)=3.944,P=0.047)。应用Cox模型单因素分析显示:GTV(HR=3.090,95%CI:1.057-8.884,P=0.036)、D100(HR=4.463,95%CI:1.261-15.798,P=0.020)、供血动脉(HR=5.885,95%CI:1.877-18.449,P=0.002)与OS显著相关,多因素分析显示:多靶动脉供血是影响OS的独立危险因素(HR=4.776,95%CI:1.265-18.039,P=0.021)。结论^(125)I放射性粒子植入治疗联合多靶动脉减量灌注化疗治疗ⅢB期NSCLC在局部病灶控制、延长生存时间方面优于联合静脉化疗,可作为治疗手段之一进行临床推广。

^(125)Ⅰ粒子植入联合支气管动脉灌注治疗中晚期肺癌的临床应用

目的评估125I粒子植入联合支气管动脉灌注化疗治疗中晚期肺癌的临床疗效。方法回顾性分析行125I粒子植入联合支气管动脉灌注化疗的中晚期肺癌患者30例的疗效和不良反应,每例粒子植入数为3～70粒(6711型,0.7mCi/粒)。所有患者分别在粒子植入术前7d、术后30、60d进行支气管动脉灌注化疗,根据RECIST标准判定疗效。结果所有患者共40个病灶均成功植入125I粒子,未发生手术相关严重并发症,术后随访2～24个月。本组患者2年生存率为86.6%(26/30),术后4个月评估疗效:CR26例,PR10例,NC2例,PD2例,总有效率为90%。结论 125I植入联合支气管动脉灌注化疗治疗中晚期肺癌疗效明显,是一种治疗中晚期肺癌安全,有效的方法之一。

鸦胆子油注射液经支气管动脉灌注治疗晚期肺癌的临床研究

目的探讨支气管动脉灌注鸦胆子油注射液及化疗药物治疗晚期非小细胞肺癌的临床疗效。方法 103例晚期非小细胞肺癌随机分为2组。对照组50例,采用单纯支气管动脉灌注化疗,治疗组98例,采用鸦胆子油注射液结合化疗药行支气管动脉灌注,观察两组毒副反应发生率,肿瘤大小变化及生活质量评分。结果治疗组治疗肿瘤客观疗效(CR+PR)达63.3%,对照组46.0%,组间比较,差异有统计学意义(P<0.01);治疗组中位生存期363天,1年累积生存率为70.4%,对照组中位生存期为305天,1年累积生存率为44.0%,组间比较,差异亦有统计学意义(P<0.01)。治疗组生活质量改善率为83.7%,对照组为62.0%,组间比较,差异有统计学意义(P<0.01)。治疗组消化道反应、骨髓抑制、肝脏毒性、肾脏毒性、心脏毒性的毒副反应低于对照组(P<0.01)。结论鸦胆子油注射液结合化疗药行支气管动脉灌注治疗晚期非小细胞肺癌能提高客观疗效,并能提高生活质量、保护免疫功能及骨髓功能。

支气管动脉灌注化疗联合静脉化疗治疗老年中晚期肺癌临床观察

目的:观察分析支气管动脉灌注化疗联合静脉化疗治疗老年中晚期肺癌的疗效。方法:老年中晚期非小细胞肺癌患者45例,均经病理诊断明确,并行支气管动脉灌注化疗及全身静脉化疗2个疗程以上,每次治疗期间均观察患者支气管动脉血管情况,应用酶联免疫吸附试验(ELISA)测定患者血清血管内皮生长因子(VEGF)的浓度并对患者进行疗效及耐受性的评价。结果:45例老年中晚期肺癌中19例治疗有效(CR+PR),占42.2%,其中血供丰富型28例,治疗有效率为46.4%,乏血供型17例,治疗有效率为35.29%。血供丰富型肺癌行支气管动脉灌注化疗联合静脉化疗有效率较乏血供型肺癌明显提高。治疗有效患者血清VEGF浓度[(69.08±51.29)ng/L]显著低于治疗前浓度[(108.10±68.88)ng/L],差异有统计学意义(t=3.32,P=0.003 8),肿瘤进展的患者血清CEGF浓度[(83.86±49.26)ng/L]与治疗前浓度[(86.49±62.28)ng/L]相仿,差异无统计学意义(t=0.27,P=0.791 3)。结论:支气管动脉灌注化疗联合静脉化疗治疗老年中晚期肺癌是一种有效的治疗方法,观察支气管动脉血供情况及VEGF的变化有利于评价老年性肺癌患者的预后。

全身化疗和支气管动脉灌注联合CIK过继免疫治疗Ⅲ期非小细胞肺癌的临床研究

背景与目的比较支气管动脉灌注化疗、全身静脉化疗和支气管动脉灌注联合CIK细胞过继免疫治疗Ⅲ期非小细胞肺癌，探讨支气管动脉灌注联合CIK细胞过继免疫治疗中晚期非小细胞肺癌的可行性。

深部热疗对老年非小细胞肺癌患者临床多项指标的研究

目的探讨支气管动脉灌注化疗联合深部热疗对老年非小细胞肺癌患者凝血功能及血清肿瘤标志物的影响,分析其提高近期疗效的可能作用机制。方法选择老年非小细胞肺癌患者124例为研究对象,采用随机数字表法分为观察组和对照组各62例,对照组采用支气管动脉灌注化疗,观察组采用支气管动脉灌注化疗联合深部热疗,治疗2个疗程后,比较两组凝血功能、肿瘤标志物、近期疗效等指标。结果观察组患者凝血酶原时间(PT)、部分活化凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)含量明显低于对照组(P<0.05,P<0.01);血清癌胚抗原(CEA)、糖类抗原125(CA125)、细胞角蛋白19片段抗原(CYFRA21-1)含量明显低于对照组(P<0.05,P<0.01);有效率、疾病控制率均明显高于对照组(P<0.05);两组消化道反应、骨髓抑制、脱发、肝功能损伤等比较无统计学意义(P>0.05)。结论支气管动脉灌注化疗联合深部热疗有助于提高老年非小细胞肺癌患者近期疗效,可能与改善患者凝血功能、降低血清肿瘤标志物含量有关。

支气管动脉灌注治疗老年肺癌临床疗效观察

目的对比分析中晚期老年肺癌经支气管动脉灌注与全身化疗的疗效。方法88例确诊的中晚期老年肺癌患者，随机分为静脉全身化疗（对照组）和经导管支气管动脉内灌注化疗药物（观察组）。间隔3～4周治疗1次，3次治疗后评价临床疗效、毒副反应，随访生存时间等，用统计学方法分析两组治疗差别。结果治疗后对照组、观察组的有效率分别为30．5％和56．5％，经χ^2分析两组间有效率差异有显著性，白细胞下降、静脉炎发生率观察组明显减少，生存时间明显延长。结论经导管支气管动脉灌注化疗疗法和全身静脉化疗相比能更有效地控制原发病灶，对老年晚期肺癌患者是一个有效的治疗方法。

吉西他滨联合顺铂动、静脉化疗治疗晚期非小细胞肺癌的疗效观察

目的探讨吉西他滨联合顺铂动、静脉联合化疗治疗晚期非小细胞肺癌(NSCLC)的疗效与安全性。方法按照随机数字表的分组方法将136例患者分为对照组和观察组,各68例。对照组给予注射用盐酸吉西他滨1 000 mg/m2、顺铂注射液50 mg/m2静脉滴注化疗治疗。观察组于第1天经支气管动脉药物灌注吉西他滨1 000 mg/m2+顺铂50mg/m2,于第8天再次给予吉西他滨1 000 mg/m2静脉滴注化疗治疗。分析2组近期治疗总有效率、生活质量改善情况及不良反应。结果观察组近期治疗总有效率高于对照组,2组差异有统计学意义(P<0.05)。观察组中鳞癌及中央型肺癌患者的临床治疗有效率分别高于腺癌及周围型肺癌患者,2组差异均有统计学意义(P均<0.05)。观察组生活质量改善率高于对照组,且与对照组比较,差异有统计学意义(P<0.05)。2组不良反应发生率经统计学比较,差异无统计学意义(P>0.05)。结论吉西他滨、顺铂动、静脉联合化疗治疗晚期NSCLC患者,可提高患者的临床治疗有效率,改善患者的生活质量,具有较高的安全性。

射频消融联合支气管动脉灌注化疗在晚期非小细胞肺癌治疗中的应用

目的研究射频消融联合支气管动脉灌注化疗在晚期非小细胞肺癌治疗中的应用价值。方法对观察组32例晚期非小细胞肺癌患者在螺旋CT定位引导下行射频消融治疗,一周后采用含顺铂的方案(紫杉醇+DDP、吉西他滨+DDP)进行支气管动脉灌注化疗,灌注治疗1～3次;选择同期接受相同化疗方案进行全身化疗的晚期非小细胞肺癌患者40例为对照组,全身化疗2～4次。比较两组的近期疗效、生存期及毒副作用。结果观察组的近期疗效(CR+PR)为78.1%对照组为37.5%,观察组和对照组有显著性差异(P<0.01)。随访6、12、24个月生存率,观察组为93.8%、75%和9.4%,对照组为67.5%、45%和2.5%,观察组明显优于对照组(P<0.01)。两组毒副作用无显著性差异(P>0.05)。结论射频消融联合支气管动脉灌注化疗是治疗晚期非小细胞肺癌的一种安全有效的方法。