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.

LONG TERM RESULTS OF BRONCHIAL ARTERIAL INFUSION WITHCHEMOTHERAPEUTIC AGENTS PLUS RADIATION THERAPYIN THE TERATMENT OF LOCALLY ADVANCEDNON SMALL CELL LUNG CANCER

Objective: To evaluate the efficacy of the bronchial arterial infusion (BAI) plus radiation therapy (RT) for locally advanced non-small-cell lung cancer (NSCLC). Methods: 79 patients with locally advanced NSCLC were divided randomly into two groups. In the RT group, the radiation was given by 8Mv X-ray or 18Mv X-ray with 2Gy/fraction, 5 fraction per week with a total dose of 60Gy～65Gy/6～7 weeks. In the BAI+RT group, the radiation was given as RT group. Bronchial arterial infusion was performed before RT. The regimen consisted of DDP 100 mg/m2, MMC 10 mg, and 5-Fu 1000 mg. Each patient received two or three cycles. Results: The overall response rates were 80.5% in BAI+RT group and 50% in RT group. The 1-, 3-, 5-year survival rates in the BAI+RT group were significantly improved when compared to the RT group, being 87.8% vs 36.8%, 39.0% vs 7.9%, and 17.1% vs 2.6% respectively. The median time of radiation treatment to recurrence of primary lesion was 11 months in the BAI+RT group and 5 months in the RT group (P<0.05). The acute reactions were increased but acceptable in BAI+RT group, and the radiation treatments were able to be completed without any break. The late reactions were similar in both groups. Conclusion: The survival rates of patients with locally advanced NSCLC can be improved by BAI+RT without increasing any complication.

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.

BACE、BAI治疗支气管肺癌的近期疗效对比研究

目的 :评价BACE与ABI治疗支气管肺癌的近期疗效。方法 :将 173例支气管肺癌分为A、B两组 ,A组 15 4例应用支气管动脉灌注药物治疗 ,B组 19例应用支气管动脉化学栓塞治疗。结果 :A、B两组总缓解率分别为 5 3 2 5 %和78 95 %两组比较差异有显著意义 (P <0 0 5 )。两组 1年生存率A(5 7 14 % )、B(73 6 8% )比较差异有显著性意义 (P <0 0 5 )。结论 :BACE治疗支气管肺癌的短期疗效优于BAI。

BAI新辅助化疗联合手术治疗老年局部晚期非小细胞肺癌

目的 观察BAI(支气管动脉灌注 )新辅助化疗治疗老年局部晚期 (Ⅲ期 )非小细胞肺癌(NSCLC)的临床和病理组织学疗效以及对提高手术切除率的作用。方法 78例老年局部晚期NSCLC患者随机分为 2组 :(1)BAI化疗组 ,先给予 1～ 2个疗程的BAI化疗后进行手术治疗 ;(2 )单纯手术组 ,确诊后直接手术。结果 BAI化疗组的临床有效率和病理组织学有效率均为 5 0 .0 %。完成 2个疗程BAI化疗患者的临床和组织学有效率均高于 1个疗程的患者 (P <0 .0 5 )。但以影像学变化为判定标准的临床疗效与组织学疗效并不完全一致。BAI化疗组的手术切除率 (84 .2 % )和完全性切除率 (5 5 .3% )均显著高于单纯手术组 (分别为 6 0 .0 %和 30 .0 % ,P <0 .0 5 )。结论 老年局部晚期NSCLC进行BAI新辅助化疗可获得良好的临床和病理组织学疗效 ,且以 2个疗程BAI化疗的疗效为佳。BAI新辅助化疗可提高老年局部晚期NSCLC的手术切除率和完全性切除率。

BAI及BAE术治疗老年中晚期肺癌的疗效观察

目的观察支气管动脉灌注化疗(BAI)及化疗栓塞术(BAE)治疗老年中晚期肺癌患者的疗效。方法采用BAI及BAE术治疗老年中晚期肺癌患者,观察其近期疗效及毒副反应。结果 32例患者中CR 2例,PR 15例,SD 7例,PD 8例,有效率为53.12%。结论采用BAI及BAE治疗老年中晚期肺癌疗效确切,且毒副反应能耐受。

Adenovirus-mediated wild-type p53 gene transfer in combination with bronchial arterial infusion for treatment of advanced non-small-cell lung cancer,one year follow-up

Objective:In the present study,we have examined the safety and efficacy of recombinant adenovirus encoding human p53 tumor suppressor gene(rAd-p53) injection in patients with advanced non-small-cell lung cancer(NSCLC) in the combination with the therapy of bronchial arterial infusion(BAI).Methods:A total of 58 patients with advanced NSCLC were enrolled in a non-randomized,two-armed clinical trial.Of which,19 received a combination treatment of BAI and rAd-p53(the combo group),while the remaining 39 were treated with only BAI(the control group).Patients were followed up for 12 months,with safety and local response evaluated by the National Cancer Institute's Common Toxicity Criteria and response evaluation criteria in solid tumor(RECIST),respectively.Time to progression(TTP) and survival rates were also analyzed by Kaplan-Meier method.Results:In the combo group,19 patients received a total of 49 injections of rAd-p53 and 46 times of BAI,respectively,while 39 patients in the control group received a total of 113 times of BAI.The combination treatment was found to have less adverse events such as anorexia,nausea and emesis,pain,and leucopenia(P<0.05) but more arthralgia,fever,influenza-like symptom,and myalgia(P<0.05),compared with the control group.The overall response rates(complete response(CR)+partial response(PR)) were 47.3% and 38.4% for the combo group and the control group,respectively(P>0.05).Patients in the combo group had a longer TTP than those in the control group(a median 7.75 vs 5.5 months,P=0.018).However,the combination treatment did not lead to better survival,with survival rates at 3,6,and 12 months in the combo group being 94.74%,89.47%,and 52.63%,respectively,compared with 92.31%,69.23%,and 38.83% in the control group(P=0.224).Conclusion:Our results show that the combination of rAd-p53 and BAI was well tolerated in patients with NSCLC and may have improved the quality of life and delayed the disease progression.A further study to better determine the efficacy of this combination therapy is warranted.

支气管镜引导下^(125)I粒子植入联合支气管动脉灌注化疗栓塞术在晚期中心型肺鳞癌中的应用效果

目的探讨采取经电子支气管镜(EB)植入^(125)I粒子+支气管动脉灌注化疗栓塞术疗法在晚期中心型肺鳞癌(LUSC)中的应用效果与安全性。方法回顾性选取2017年6月至2020年2月福建医科大学附属闽东医院收治的68例Ⅲb~Ⅳ期中心型LUSC患者作为研究对象,按不同治疗方法将其分为联合治疗组(n=32)与单纯灌注化疗栓塞组(n=36)。联合治疗组患者采取经EB植入^(125)I粒子+支气管动脉灌注化疗栓塞术疗法;单纯灌注化疗栓塞组患者采取支气管动脉灌注化疗栓塞术疗法。两组患者均采用吉西他滨(GEM)+顺铂(DDP)化疗方案,于干预后l、3、5个月实施EB与CT检查,比较两组患者的疗效与不良反应。结果联合治疗组的疗效优于单纯灌注化疗栓塞组,差异有统计学意义(P<0.05)。联合治疗组的咯血发生率高于单纯灌注化疗栓塞组,差异有统计学意义(P<0.05)。两组患者的骨髓抑制、发热与气胸发生率比较,差异无统计学意义(P>0.05)。发生的各不良反应皆为轻度,在可控范围内。结论经EB植入^(125)I粒子+支气管动脉灌注化疗栓塞术可获得较好的近期疗效,其用于晚期中心型LUSC的治疗具备安全性、微创性。

支气管动脉灌注化疗联合栓塞术对非小细胞肺癌患者的影响研究

分析了采用支气管动脉灌注化疗联合栓塞术治疗非小细胞肺癌的应用价值。选取贵州医科大学附属白云医院2019年1月—2019年12月收治的90例非小细胞肺癌患者为研究对象,分为对比组和研究组。对比组(n=45)接受支气管动脉灌注治疗,研究组(n=45)在对比组基础上联合应用栓塞术。观察两组患者的临床治疗总有效率、并发症发生率、不良反应情况。患者接受临床远期疗效的对比,包括两组患者1、2、3年的生存率比较分析,同时比较两组的血清肿瘤标志物、血清炎性因子、T淋巴细胞亚群比较。不仅如此,还需要将两组患者的临床治疗总依从率进行对比分析。研究发现,支气管动脉灌注化疗联合栓塞术在非小细胞肺癌患者中的应用,实现了患者治疗总有效率的提升,并且有效降低了患者并发症发生率与不良反应问题的出现,患者的生存率得到了保证,血清炎性因子改善明显,T淋巴细胞亚群显著提升,对于患者治疗总依从率提升也有一定的促进意义。

支气管动脉灌注-全身化疗序贯治疗中晚期非小细胞肺癌随机对照研究

背景与目的肺癌临床诊断时多为晚期,中晚期肺癌治疗效果欠佳,本研究对比分析中晚期非小细胞肺癌经支气管动脉灌注化疗、全身静脉化疗、支气管动脉灌注化疗加全身化疗序贯治疗的疗效,以期寻找中晚期非小细胞肺癌更理想的治疗方法。方法中晚期非小细胞肺癌127例,均经病理证实,按自愿及随机原则分为支气管动脉灌注化疗、全身静脉化疗与支气管动脉灌注化疗加全身化疗序贯治疗组。结果肺内原发灶有效率(CR+PR)介入治疗组,静脉化疗组,序贯治疗组分别为59.22%、30.23%、69.05%。经统计学分析,原发灶总有效率介入治疗组较静脉化疗组显著提高(P<0.01),序贯治疗组较静脉化疗组显著提高(P<0.01),介入治疗组与序贯治疗组无显著性差异(P>0.05)。肺外转移灶有效率介入治疗组,静脉化疗组,序贯治疗组分别为18.19%、53.85%、60.00%,转移灶有效率介入治疗组显著低于静脉化疗组(P<0.05),序贯治疗组较介入治疗显著提高(P<0.01),静脉化疗组与序贯治疗组无显著性差异(P>0.05)。结论支气管动脉灌注化疗加全身化疗序贯治疗既可有效控制肺内病灶又对远处转移有良好预防和控制的作用,值得进一步推广。

肺癌支气管动脉灌注化疗引起食管支气管瘘

作者自1986～1994年间对1200例中晚期肺癌病人,径4000余人次的支气管动脉灌注(BAD 抗癌药物治疗,发生食管炎7例,占7/4000(1.75‰);食管支气管瘘3例,占3/4000(0.75‰),这三例中1例经手术修补成活,2例死亡。作者提出发生食管支气管瘘的主要原因是左、右支气管动脉均有分支供血食管,当较高浓度的5Fu,阿霉素或丝裂霉素灌注治疗后,引起食管炎、溃疡、直至穿孔,瘘管形成。并对这一并发症的诊断与鉴别诊断、治疗和预防作较详细的讨论。

非小细胞肺癌的介入治疗现状

肺癌是我国最常见的恶性肿瘤之一。据2010年我国卫生统计年鉴显示,2005年肺癌死亡率占我国恶性肿瘤死亡率的第1位。其中非小细胞肺癌(non-small-cell lung cancer,NSCLC)约占所有肺癌的85%,大部分患者确诊时已为中晚期,已丧失手术根治切除的机会,5年生存率在15%左右。介入治疗因其操作简单、局部疗效好、不良反应小、可重复性好等特点,目前已成为中晚期NSCLC非手术治疗的重要方法,并已广泛应用于临床。本文对NSCLC的介人治疗现状及进展作一综述。

支气管肺癌介入治疗的临床研究

目的 探讨经皮支气管动脉灌注化疗和灌注化疗栓塞治疗中晚期肺癌的临床效果。资料与方法 对 5 7例肺癌患者施行了经皮支气管动脉灌注化疗或灌注化疗栓塞术。采用改良式Seldinger技术 ,行选择性和超选择性支气管动脉插管。经导管注入超液化碘油 (3～ 10ml)和吡柔比星 (10mg)的混悬液 ,然后注入另外 2种化疗药物 ,咳血患者最后用明胶海绵颗粒适量栓塞肿瘤周围小血管 ,支气管动脉主干保持通畅。结果 40例为富血管型(70 .18% ) ,17例 (2 9.82 % )为乏血管型。现存 15例中 ,半年生存率 10 0 % ,1年生存率 80 .0 0 %。死亡 33例 ,中位生存期 14.75个月 ,半年生存率 96 .97% ,1年生存率 73.33% ,2年生存率 33.81% ,3年生存率 9.0 9%。结论 经皮支气管动脉灌注化疗栓塞 ,三明治方法是治疗中晚期肺癌的最有效方法之一。可以确切延长中位生存期 ,提高患者生存质量。长期疗效需要大量随机增加病例及长期随访 。

支气管动脉灌注化疗治疗肺癌的临床研究

目的 探讨支气管动脉灌注化疗 (BAI)对中晚期肺癌的疗效及影响因素。方法 对 45例中晚期肺癌进行BAI治疗 ,与同期接受全身化疗的 40例中晚期肺癌进行比较。结果 除开 1例大细胞肺癌 ,BAI组完全缓解 (CR) 15例 ( 3 4.1% ) ,部分缓解 (PR) 18例 ( 4 0 .9% ) ,缓解 (CR +PR) 3 3例 ,缓解率 75 .0 % ,与全身化疗之间的疗效 ( 5 0 .0 % )有显著性差异 ,前者优于后者 (P <0 .0 5 ) ,前者毒副反应亦少于后者 (P <0 .0 5 ) ,但BAI组有 1例灌注后截瘫。在BAI组中 ,小细胞未分化癌、鳞癌、腺癌的缓解率分别为 94.5 %、66.6%、40 .0 %。BAI组鳞癌和腺癌的缓解率显著高于全身化疗组 (P <0 .0 5 )。结论 BAI的疗效优于全身静脉化疗 ,且毒副反应低。鳞癌首选BAI治疗 ,小细胞未分化癌以全身化疗为基础 ,辅助应用BAI治疗 ,腺癌可先行BAI治疗 。

p53基因(今又生~)联合支气管动脉化疗治疗肺癌15例近期疗效观察

目的探讨瘤内注射或经支气管动脉灌注p53基因联合支气管动脉灌注化疗（BAI）治疗肺癌的安全性、疗效和给药途径.方法经病理证实的15例肺癌,首先在CT引导下经皮穿刺瘤内注射或经支气管动脉灌注p53基因（今又生（R））,2～5天后,行BAI灌注化疗药物;然后根据病情变化再次进行基因治疗和/或BAI.治疗后常规使用螺旋CT定期复查,评价治疗效果.结果全部15例患者均完成上述治疗,并接受随访2～11个月.有效率（CR＋PR）46.7%（7/15）,1例肺部肿块消失,6例肺部肿块缩小,3例纵隔淋巴结缩小,1例胸水减少,仅1例观察到肿瘤长大,14例临床症状有不同程度缓解93.3%（14/15）.p53治疗后6例出现发热（38℃～40℃）,未观察到基因药物的其它严重副作用,无严重操作有关并发症出现.结论本研究结果初步显示,作为肿瘤综合治疗的一部分,p53基因治疗与BAI联合应用,是一种治疗肺癌安全、有效的方法,提高了BAI的治疗效果.经皮瘤内注射p53是否为一种较好的给药途径值得进一步探讨.

中药配合支气管动脉灌注化疗治疗非小细胞肺癌的临床观察

目的 :探讨中药配合支气管动脉灌注化疗 (BAIC)治疗肺癌的疗效。方法 :中晚期非小细胞肺癌 (NSCLC) 76例 ,随机分A、B两组。A组 39例为BAIC加中药治疗组 ,B组 37例为单纯BAIC组。观察比较两组近期疗效、远期生存率、临床主要症状变化、生存质量及外周血象变化情况。结果 :治疗后稳定加有效率 (CR +PR +NC)A、B组分别为 92 31%、70 2 7% ,组间比较差异有显著性 (P <0 0 5)。 0 5、1、2年生存率A组分别为 79 4 9%、56 4 1%、51 2 8% ;B组分别为 72 97%、51 35%、2 4 32 % ;2年生存率A组优于B组 (P <0 0 5)。在改善临床症状、卡氏评分、增加体重 ,以及对治疗后外周血象变化的改善方面 ,A组患者比B组更明显。结论 :中药配合BAIC可以提高BAIC效果。

支气管动脉灌注化疗加栓塞治疗肺癌的临床应用研究

本文报告经支气管动脉灌注化疗与栓塞治疗的中晚期肺癌20例,其中小细胞肺癌14例,腺癌4例,鳞状细胞癌2例.属于Ⅱ期6例,Ⅲ期14例.选择性支气管动脉造影均表现为多血管型.20例均经支气管动脉先灌注地塞米松10mg,阿霉素40～50mg;再将丝裂霉素20mg用5-FU1.0～1.5ml溶解,再加40％碘化油1～3ml,充分混合后,进行支气管动脉栓塞.疗效明显,术后1～6个月复查,总有效率为100％.

术前支气管动脉灌注化疗治疗Ⅲa(N_2)期非小细胞肺癌

目的探讨术前支气管动脉灌注(BAI)化疗在Ⅲa(N2)期非小细胞肺癌(NSCLC)治疗中的临床应用价值。方法临床确诊的Ⅲa(N2)期非小细胞肺癌186例,随机分为观察组和对照组,每组93例。观察组患者在接受2次BAI后手术,对照组确诊后直接手术,观察BAI疗效,比较两组患者的手术情况和术后生存率。结果观察组的临床和组织学有效率分别为80.6%和83.9%,TNM分期下降50.53%,不良反应轻微;观察组根治性手术切除率为93.4%,显著高于对照组的72.0%,差异有统计学意义(P<0.05);术中出血量和术后并发症两组间无差别;观察组与对照组1、3、5年生存率分别为97.8%、64.8%、36.3%和89.3%、50.5%、18.3%,两组间差异有显著统计学意义(P<0.01)。结论术前BAI可获得较好的临床和组织学疗效,并能提高Ⅲa(N2)期NSCLC的根治性手术切除率和术后生存率,值得临床推广应用。

无水酒精瘤内注射结合灌注化疗治疗周围型肺癌初步探讨

应用无水酒精瘤内注射（ＰＡＩ）并结合支气管动脉灌注化疗（ＢＡＩ）治疗１２例周围型肺癌患者，其中１例单纯ＰＡＩ治疗后手术切除，对其标本进行了详细的病理组织学研究。余１１例均应用ＰＡＩ结合ＢＡＩ治疗，治疗有效率１００％，显效率８１．８％。研究结果表明，对于周围型肺癌，应用ＰＡＩ治疗安全有效，但单独应用尚有一定限度，而ＰＡＩ同时结合ＢＡＩ治疗既能治疗原发灶，又能控制转移灶，且对大病灶肺癌也能取得较好疗效，从而克服了单纯ＰＡＩ的限度，是一种较好的综合性治疗方案。

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