Assessment of the efficacy and safety of bronchial artery perfusion chemotherapy combined with high-frequency hyperthermia for advanced non-small cell lung cancer

Objective:To study the efficacy and safety of bronchial artery perfusion chemotherapy combined with high-frequency hyperthermia for advanced non-small cell lung cancer. Methods:Patients with advanced non-small cell lung cancer who were treated in Navy General Hospital between May 2014 and October 2016 were selected and randomly divided into two groups, the observation group received bronchial arterial infusion chemotherapy combined with high-frequency hyperthermia, and the control group received bronchial arterial infusion chemotherapy. Before and after treatment, the expression of tumor activity indexes and liver and kidney function indexes in serum as well as and proliferation and invasion genes in tumor lesions were detected respectively.Results: 5 d and 7 d after treatment, serum CEA, MIF, CYFRA21-1 and HE4 levels of both groups of patients were significantly lower than those before treatment and serum CEA, MIF, CYFRA21-1 and HE4 levels of observation group were significantly lower than those of control group;7 d after treatment, MEF2D, c-myc, Survivin, Bcl-2, Vimentin, N-cadherin and Slug expression in tumor lesions of both groups of patients were significantly lower than those before treatment and MEF2D, c-myc, Survivin, Bcl-2, Vimentin, N-cadherin and Slug expression in tumor lesions of observation group were significantly lower than those of control group;serum Scr, BUN, ALT and AST levels were not significantly different between two groups of patients before and after treatment. Conclusion:Bronchial artery perfusion chemotherapy combined with high-frequency hyperthermia for advanced non-small cell lung cancer can significantly inhibit the tumor proliferation and invasion and is with ideal safety.

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.

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.

Effects of combined treatment of bronchial arterial chemoembolization and radioactive particle implantation on tumor markers and T lymphocyte subsets in locally advanced non-small cell lung cancer

Objective: To investigate the effects of bronchial arterial chemoembolization combined with radioactive particle implantation on the level of serum tumor markers and T lymphocyte subsets in patients with locally advanced non-small cell lung cancer. Methods: A total of 91 cases of locally advanced non-small cell lung cancer patients according to the random data table were divided into the control group (n=45) and observation group (n=46) according to the random data table. Patients in the control group was treated with bronchial arterial chemoembolization, on the basis of the control group, patients in the observation group were treated with radioactive particle implantation, the serum tumor markers and T lymphocyte subsets of the two groups were compared before and after treatment. Results: The levels of CEA, NSE, CA125, CD4+, CD8+, CD4+/CD8+ and NK in the two groups before the treatment were not statistically significant. Compared with the group before treatment, levels of CEA, NSE, CA125and CD8+ of the two groups after treatment were significantly decreased, and after treatment the level of CEA, NSE, CA125and CD8+ in the observation group was significantly lower than those of the control group;The levels of CD4+, CD4+/CD8+ and NK in the two groups after treatment were significantly higher than those in the group before treatment, and the observation group levels were significantly higher than those of the control group. Conclusion: Bronchial artery embolization combined with radioactive particle implantation for locally advanced non-small cell lung cancer, can effectively reduce the serum tumor markers level, improve the level of T cell subsets of patients, has important clinical value.

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.

LAK细胞和白介素Ⅱ配合化疗药物支气管动脉灌注治疗晚期肺癌

目的:探讨LAK细胞和白介素Ⅱ配合化疗药物支气管动脉灌注治疗晚期肺癌的价值。方法:将40例晚期肺癌随机分为两组:LAK细胞和白介素Ⅱ配合化疗药物支气管动脉灌注20例为观察组;单纯化疗药物支气管动脉灌注20例为对照组。对两组病例的疗效、生存率和生活质量分别作x2检验,进行对照分析。结果:观察组首次治疗的近期疗效50％（10/20）,与对照组30％（6/20）比较,差异无显著性（x2=1.67,P>0.05）;但观察组1年生存率95％（19/20）,与对照组45％（9/20）比较,有高度显著性差异（x2=11.90,P<0.01）,且观察组较对照组生活质量明显提高（P<0.01）。结论:LAK细胞和白介素Ⅱ配合化疗药物支气管动脉灌注,可能是晚期肺癌较为有效的治疗方法。

支气管动脉灌注LAK细胞和化疗药物联合治疗肺癌的护理

对10例中晚期肺癌患者采用支气管动脉灌注LAK细胞和化疗药物联合治疗，取得良好疗效。充分做好术前准备，水中医护密切配合，严格执行无菌操作，加强留置导尿护理，仔细观察用药后不良反应以及做好拔管后的护理，对提高疗效、减少副作用有重要意义。10例患者26次治疗无非发症发生。

吉西他滨载药微球经支气管动脉化疗栓塞治疗中晚期不可切除肺鳞状细胞癌的临床研究

目的探讨吉西他滨载药微球经支气管动脉化疗栓塞治疗中晚期不可切除肺鳞状细胞癌的临床疗效与安全性。方法收集2020年10月至2022年5月马鞍山市人民医院收治的32例中晚期不可切除肺鳞状细胞癌患者的临床资料,根据治疗方案的不同将患者分为A组(n=16,采用吉西他滨+顺铂或卡铂化疗)、B组(n=8,给予支气管动脉灌注化疗,即白蛋白结合型紫杉醇200 mg+顺铂60 mg)和C组(n=8,给予支气管动脉灌注化疗,即吉西他滨600 mg+顺铂60 mg,灌注化疗后使用载药微球吉西他滨600 mg,之后静脉补充顺铂60 mg+吉西他滨800~1200 mg)。比较3组患者的治疗结局,包括客观缓解率(ORR)、疾病控制率(DCR)、临床疗效及总生存期。结果治疗后,3组患者ORR、DCR、临床疗效以及总生存期超过12个月的比例比较,差异均无统计学意义(P﹥0.05)。治疗后,部分患者发生药物相关不良反应,其中,3组患者恶心呕吐、腹泻、骨髓抑制、肝功能损伤及肾功能损伤的发生率比较,差异均无统计学意义(P﹥0.05);3组患者食欲减退和脱发的发生率比较,差异均有统计学意义(P﹤0.05)。结论吉西他滨载药微球经支气管动脉化疗栓塞治疗中晚期不可切除肺鳞状细胞癌的疗效、安全性与单纯全身化疗和支气管动脉灌注化疗相近,可以作为后两种治疗方案的替代方案。

养肺益气汤联合载药微球支气管动脉化疗在非小细胞肺癌治疗中的临床效果分析

目的:分析养肺益气汤联合载药微球支气管动脉化疗治疗非小细胞肺癌的临床效果。方法:选择2020年1月—2023年1月启东市中医院肿瘤科收治的82例非小细胞肺癌患者,根据随机数表法分为化疗组、联用组,各41例。其中化疗组采用载药微球支气管动脉化疗治疗,而联用组采用养肺益气汤联合载药微球支气管动脉化疗治疗。比较两组肿瘤标志物、中医症候积分、毒副作用发生率。结果:治疗前,两组肿瘤标志物比较,差异无统计学意义(P>0.05);治疗后,两组肿瘤标志物均低于治疗前,且联用组低于化疗组,差异有统计学意义(P<0.05)。治疗前,两组中医症候积分比较,差异无统计学意义(P>0.05);治疗后,两组中医症候积分均低于治疗前,且联用组低于化疗组,差异有统计学意义(P<0.05)。联用组毒副作用总发生率低于化疗组,差异有统计学意义(P<0.05)。结论:在针对非小细胞肺癌进行治疗时,在载药微球支气管动脉化疗基础上予以养肺益气汤治疗能够进一步控制癌症病变,缓解各项临床症状,并降低毒副作用发生的可能性。

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。

支气管动脉灌注白蛋白紫杉醇+洛铂化疗联合动脉栓塞治疗晚期非小细胞肺癌的临床效果

目的探讨晚期非小细胞肺癌(Non-small Cell Lung Cancer,NSCLC)患者采用支气管动脉灌注白蛋白紫杉醇(Nanoparticle Albumin Bound Paclitaxel,NAB-PTX)+洛铂(Lobaplatin,LBP)化疗联合动脉栓塞治疗的临床效果。方法选取2021年2月—2023年10月曹县人民医院收治的40例晚期NSCLC患者为研究对象,以随机数表法分为研究组和对照组,各20例。两组均给予动脉栓塞治疗,对照组给予支气管动脉灌注NAB-PTX+顺铂(Cisplatin,DDP)化疗,研究组给予支气管动脉灌注NAB-PTX+LBP化疗,比较两组近期疗效及血清肿瘤标志物水平。结果研究组客观缓解率为65.00%,高于对照组的30.00%,差异有统计学意义(χ^(2)=4.912,P<0.05)。治疗后两组糖类抗原125、癌胚抗原水平均下降,且研究组较对照组更低,差异有统计学意义(P均<0.05)。结论支气管动脉灌注NAB-PTX+LBP化疗联合动脉栓塞应用于晚期NSCLC患者治疗中,可以提高临床疗效,降低血清肿瘤标志物水平。

支气管动脉化疗栓塞术在晚期非小细胞肺癌患者中的应用效果

目的探讨支气管动脉化疗栓塞术(BACE)+重组人血管内皮抑制素+程序性死亡受体1(PD-1)抑制剂在晚期非小细胞肺癌(NSCLC)患者中的应用效果。方法根据治疗方法的不同将60例晚期NSCLC患者分为A组(n=28)和B组(n=32),A组患者接受静脉化疗+重组人血管内皮抑制素+PD-1抑制剂治疗,B组患者接受BACE+重组人血管内皮抑制素+PD-1抑制剂治疗。比较两组患者的临床疗效、生活质量改善情况、T细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平及不良反应发生情况。结果B组患者治疗总有效率、生活质量改善率均高于A组,不良反应总发生率低于A组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均高于本组治疗前,CD8^(+)水平均低于本组治疗前,B组患者CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均高于A组,CD8^(+)水平低于A组,差异均有统计学意义(P﹤0.05)。结论BACE+重组人血管内皮抑制素+PD-1抑制剂治疗晚期NSCLC患者安全有效,能够改善患者的生活质量和T细胞亚群水平,降低不良反应发生率。

支气管动脉化疗栓塞联合^(125)I粒子植入治疗老年性非小细胞肺癌疗效分析

目的探讨支气管动脉化疗栓塞联合125I放射性粒子植入治疗老年性非小细胞肺癌(NSCLC)的安全性、有效性,并与吉西他滨联合顺铂(GP)方案化疗的近期疗效进行对比分析。方法 82例Ⅲa~Ⅲb期不可手术切除的老年性NSCLC患者随机分成两组,研究组38例,行支气管动脉化疗栓塞联合125I放射性粒子植入治疗3~6个疗程;对照组44例行GP方案4~6个疗程全身静脉化疗,对比分析两组患者的疗效、不良反应发生率及生存率。结果研究组和对照组患者的治疗有效率分别为71.1%和43.2%(P<0.05),差异有统计学意义。局部控制率分别为84.2%和64.1%,差异无统计学意义(P>0.05)。研究组与对照组1年生存率分别为71.1%和52.1%,中位生存时间分别为399 d和336 d,差异均有统计学意义(P均<0.05)。研究组的不良反应率明显比对照组低,差异有统计学意义(P<0.05),其中125I放射性粒子植入的主要并发症为气胸。结论支气管动脉化疗栓塞联合125I放射性粒子植入治疗不可手术切除的Ⅲ期老年性NSCLC是一种安全、有效的治疗方法,毒副作用低,短期疗效优于GP方案化疗,是现阶段治疗老年晚期NSCLC患者的新选择。

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。

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。

^125I粒子植入治疗非小细胞肺癌近期疗效评估

目的探讨125I粒子植入治疗非小细胞肺癌(NSCLC)介入综合治疗的近期疗效、可行性、安全性。方法 2010年6月—2012年12月,治疗符合标准肺癌患者为56例,将其分成治疗组A组(24例)和对照组B组(32例)。A组给以支气管动脉化疗药物灌注术,术后给以125I粒子植入术。B组单纯给以支气管动脉化疗药物灌注术。结果 A组中位生存期(22.8±1.9)个月,B组中位生存期(14.2±1.3)个月。A组显著长于B组(P=0.006)。结论125I粒子植入联合动脉化疗治疗中晚期NSCLC与单纯动脉化疗相比能够明显的提高患者的生存质量和延长患者的生存期,是治疗中晚期NSCLC的一种有效的方法,值得临床广泛应用。

体外留置导管经支气管动脉大剂量灌注免疫及化疗药物治疗Ⅲ期非小细胞肺癌的临床疗效观察

目的 评价体外留置导管经支气管动脉大剂量灌注免疫及化疗药物治疗Ⅲ期非小细胞肺癌的临床疗效及安全性。资料与方法 39例经病理组织学证实的Ⅲ期非小细胞肺癌患者随机分为免疫化疗组和对照组 ,分别进行经体外留置导管支气管动脉灌注免疫及化疗药物和单纯支气管动脉灌注化疗药物 3次。结果 大剂量灌注免疫化疗组和单纯支气管动脉灌注化疗组的近期有效率分别为 90 %和 6 3% ,两组间具有显著性差异 (P <0 .0 5 )、中位生存期分别为 17.6个月和 10 .3个月 ,有显著性差异 (P <0 .0 1) ,无脊髓动脉损伤等严重并发症。结论 经体外留置导管行支气管动脉大剂量灌注免疫及化疗药物治疗Ⅲ期非小细胞肺癌在严格掌握手术指征的条件下是安全、可行的 。

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

支气管动脉灌注紫杉醇联合全身化疗治疗晚期非小细胞肺癌

目的 观察选择性经支气管动脉灌注紫杉醇 (泰素 )及卡铂并联合紫杉醇全身化疗治疗晚期非小细胞肺癌 (NSCLC)的疗效及不良反应。方法 对 5 7例晚期NSCLC患者经支气管动脉注入紫杉醇和卡铂 ,同时予紫杉醇全身化疗 ,每例均完成 2～ 3周期后评价其疗效及不良反应。结果 5 7例中完全缓解 (CR) 6例 ,部分缓解 (PR) 2 8例 ,总有效率 5 9.6 %。主要不良反应为骨髓抑制、胃肠道反应、脱发等 ,不良反应多为Ⅰ～Ⅱ度。结论 经支气管动脉灌注紫杉醇和卡铂并联合紫杉醇全身化疗是治疗晚期非小细胞肺癌的一种有疗效好。