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.

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.

Successful Treatment of Intra-Arterial Peplomycin Infusion for Recurrent Oral Florid Papillomatosis

A 56-year-old woman had noticed the erosion of oral mucosa and tongue 8 years ago. The mucosal lesions had been initially diagnosed as oral lichen planus and resistant to various treatments with prednisolone, etretinate and mizoribine and so on. One year ago, rapidly growing verrucous lesion occurred on her upper lip. Although we administered intralesional radiation therapy, the tumor recurred and new whitish lesions on the buccal mucosa and hard palate occurred 9 months after treatment. We confirmed an anatomical blood supply to the tumors by a fluorescent real-time imaging system and subsequently administered the intra-arterial infusion of peplomycin through retrograde catheters from bilateral superficial temporal arteries under the final diagnosis as oral florid papillomatosis (OFP). The tumors were dramatically shrunk and did not recur 16 months after treatment. OFP is known as clinically multiple whitish and verrucous lesions over the oral cavity and lip and a subtype of SCC with high differentiation. We suppose that an intra-arterial infusion therapy of peplomycin should be considered as the curative treatment for OFP.

Effect of neoadjuvant chemotherapy on locally advanced cervical cancer by internal iliac arterial infusion

Objective:To evaluate the effect of preoperative chemotherapy on locally advanced cervical cancer by internal iliac arterial infusion.Methods:Sixty two patients with bulky or locally advanced cervical cancer from 1999 to 2004 were underwent internal iliac arte- rial infusion chemotherapy by using Seldinger technique.Combined regimens were applied in- cluding cisplatin as the major drug.Two weeks later,all patients received radical hysterectomy. Results:The local tumor regression rate was 93.55%.Postoperative pathologic examination showed that no cervical tumor residue in stumps were found in 61 of 62 patients who underwent radical hysterectomy.Large quantity of necrotic tissue appeared on primary tumor.In 16 patients with positive lymph nodes,15 demonstrated necrotic lymph nodes.Conclusion:Internal iliac ar- terial infusion chemotherapy could effectively reduce tumor volume,increase surgical success rate and decrease lymph nodes and subclinical metastasis rates.

Intra-arterial chrono-chemotherapy for liver metastasis arised from colorectal cancer

Objective To evaluate the toxic effects and efficacy of the intra-arterial chrono-chemotherapy on patients with liver metastasis arised from colorectal cancer. Methods Chemotherapy of 42 patients were randomly divided into group A (n = 20) with continuously constant arterial infusion, and group B (n = 22) with arterial chrono-modulated infusion. And the toxic effects and efficacy of two groups were compared. Results A significant difference was found in the toxic effects of digestive system between the two groups. The treatment response was similar in the two groups. Conclusions Intra-arterial chrono-chemotherapy may decrease the toxic effects and improve the life quality of these patients. (J Intervent Radiol, 2006, 15: 487-490)

支气管动脉灌注联合载药微球化疗栓塞术治疗不可切除性肺癌合并咯血的临床效果观察

目的研究支气管动脉灌注联合载药微球化疗栓塞术治疗不可切除性肺癌合并咯血的临床效果。方法选取2022年2月至2024年2月我院治疗的160例不可切除性肺癌合并咯血患者为研究对象,采用随机数字表法分为对照组和观察组各80例。对照组采用支气管动脉灌注化疗栓塞术治疗,观察组在对照组基础上联合载药微球化疗栓塞术治疗,均治疗3个月,比较两组患者的临床疗效、咯血量及并发症发生率。结果观察组治疗总有效率为92.50%,高于对照组的81.25%,差异有统计学意义(P<0.05);治疗后3、5、7 d,观察组咯血量较对照组少,差异有统计学意义(P<0.05);观察组并发症发生率为5.00%,低于对照组的17.50%,差异有统计学意义(P<0.05)。结论支气管动脉灌注联合载药微球化疗栓塞术治疗不可切除性肺癌合并咯血的临床效果较好,可显著减少患者咯血量,降低并发症发生率。

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 lnstitute＇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 ofrAd-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, com- pared 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.

Effect of multiple-phase regional intra-arterial infusion chemotherapy on patients with resectable pancreatic head adenocarcinoma

Background Regional intra-arterial infusion chemotherapy （RIAC） has been more valuable to improve prognosis and quality of life of patients with inoperable pancreatic adenocarcinomas, and adjuvant RIAC plays an important role in prolonging survival and reducing risk of liver metastasis after radical resection of pancreatic cancer, but the effect of preoperative or multiple-phase RIAC （preoperative combined with postoperative RIAC） for resectable pancreatic cancers has not been investigated. In this prospective study, the effect of multiple-phase RIAC for patients with resectable pancreatic head adenocarcinoma was evaluated, and its safety and validity comparing with postoperative RIAC were also assessed. Methods Patients with resectable pancreatic head cancer were randomly assigned to two groups. Patients in group A （n=-50） were treated with new therapeutic mode of extended pancreaticoduodenectomy combined with multiple-phase RIAC, and those in group B （n=-50） were treated with extended pancreaticoduodenectomy combined with postoperative RIAC in the same period. The feasibility, compliance and efficiency of the new therapeutic mode were evaluated by tumor size, serum tumor markers, clinical benefit response （CBR）, surgical complications, mortality and toxicity of RIAC. The disease-free survival time, median survival time, incidence of liver metastasis, survival rate at 1, 2, 3 and 5 years were also observed. Life curves were generated by the Kaplan-Meier method. Results The pain relief rate and CBR in group A was 80% and 84% respectively. Serum tumor markers decreased obviously and tumors size decreased in 26% of patients after preoperative RIAC in group A. No more surgical complications, mortality or severe systemic side effects were observed in group A compared with group B. The incidence of liver metastasis in group A was 34% which was lower than 50% in group B. The disease-free survival time and median survival time in group A were 15.5 months and 18 months respectively. The 1-, 2-, 3- and 5-year survival rates were 54.87%, 34.94%, 24.51% and 12.25% respectively. There was no significant difference of survival time or survival rates between two groups. Conclusions Multiple-phase RIAC is effective in combined therapy of resectable pancreatic head carcinomas by enhancing inhibition of tumor growth and reduction of liver metastasis, without negative effect on patients＇ safety or surgical procedure.

Quality Assessment of Clinical Research on Liver Cancer Treated by Intra-Arterial Infusion of Chinese Medicine

Objective：To assess the methodological quality of clinical research on Chinese medicine（CM）applied by infra-arterial infusion in treating primary liver cancer（PLC）.Methods：Cochrane Central Register of Controlled Trials（CENTRAL）,PubMed,and three Chinese databases,including Chinese BioMedical Database（CBM）,China National Knowledge Infrastructure（CNKI）and China Academic Journal（VIP）were searched.Chinese articles were also searched manually in 16 journals.Two reviewers independently selected studies,the quality of literatures were assessed according to the Cochrane Collaboration method of quality assessment.Results：A total of 14 articles met the inclusion criteria for this review.Only three of these articles described the randomization method used.None of the studies was blinded.All of the articles didn＇t report the calculation of the sample size.Only six studies mentioned adverse reactions.All of the studies were of grade C according to the Cochrane Collaboration method.Six studies reported results of survival,and only two of these reported better efficacy in the treatment groups.Conclusions：The quality of studies concerned intra-arterial infusion of CM in treating with PLC was poor and the exact effect of these medicines still need evaluation.Well designed RCTs with large sample sizes,adequate follow-up data and reliable methods of assessment are needed to better appraise the real effect of CMs in the treatment of PLC patients.

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。

平阳霉素碘油乳剂兔耳动脉灌注的实验研究

目的 探讨平阳霉素碘油乳剂 (PLE)对正常兔耳动脉是否具有祛血管作用及PLE作为一种栓塞剂的可能性。材料与方法 19只新西兰大白兔双侧耳廓后动脉 (PAA)分别灌注PLE(右耳为实验组 )和泛影葡胺碘油乳剂MDLE(左耳为对照组 ) ,观察不同时期兔双耳大体及耳廓后动脉组织学变化 ,比较两组血管组织学变化的差异性。结果 ( 1)实验组兔耳轮廓呈缺血性梗死表现。1～ 3天时水肿 ,4～ 7天水肿加重 ,8～ 14天耳廓下缘部分坏死脱落 ,15～ 2 8天脱落缘愈合。对照组 1～ 3天时亦水肿 ,4～ 7天水肿减轻 ,8天后恢复正常。( 2 )实验组耳廓后动脉光镜下表现 :1～ 3天时血管内膜结构完整 ,仅肌层水肿 ;4～ 7天内膜部分脱落 ,水肿加重 ;8～ 14天血管内血栓形成 ,15～ 90天血管部分再通。对照组耳廓后动脉 1～ 3天时改变与实验组相同 ,4～ 7天肌层水肿减轻 ,8～14天恢复正常。观察期内耳廓后动脉组织学变化两组间有明显差异 (P <0 .0 5 )。结论 PLE对兔耳动脉具有祛血管作用 ,可作为一种动脉栓塞剂 。

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。

口腔癌持续性动脉灌注新辅助化疗的疗效观察

目的:观察区域性持续动脉灌注新辅助化疗对口腔癌的疗效及不良反应。方法:53例口腔癌患者经颞浅动脉逆行插管,微量注射泵持续动脉灌注卡铂、5-Fu。观察化疗前、后原发肿瘤灶和颈淋巴结大小,评估化疗后标本的病理学分级,记录化疗的主要不良反应。结果:前3次化疗的完全缓解率分别为:58.49%、76.60%和84.62%;化疗后分级中,Ⅲ+Ⅳ级的百分比分别为:33.33%、61.90%和80.77%;部分淋巴结出现不同程度的缩小;不良反应轻微。结论:经颞浅动脉插管持续灌注化疗的完全缓解率高,且多次化疗的疗效优于单次化疗;有利于对原发灶的完全切除。

介入导向下Ad-p53基因治疗晚期恶性肿瘤的临床安全性初步观察

目的：观察介入导向下经动脉导管系统灌注p53重组腺病毒（Ａd-p53)进行恶性肿瘤基因治疗的安全性。方法：选择经放化疗无效或复发及因故不能进行常规治疗的中晚期肿瘤患者１５例，经瘤组织主要供血动脉进行１.5×10^10-2.8±10^11pfu/次、累积剂量为９.5×10^10-1.40×10^12pfu/例的Ａd-p53基因治疗（其中５例宫颈癌病人联合化疗并观察出现的副作用。结果：临床观察发现以发热、流感样症状为主的５种不良反应，其中发热８例，流感样症状２例，胃不适、腹泻及心动过速 各１例；血常规检查发现白细胞和血小板减少各１例，血红蛋白减少２例；肝肾功能检查发现转氨酶ＣＧＴ、ＡＳＴ升高２例；治疗前后未见心电图改变（只有１例在化疗开始当天出现心动过速，第２天又恢复正常），与化疗联合治疗未产生强于单纯化疗的副作用。上述毒副反应以Ⅰ级反应为主（占８６.8%)，无Ⅲ、Ⅳ级反应。结论：在所用试剂量范围内Ａd-p53经动脉局部用药及与化疗联合治疗是安全可行的。

大咯血的支气管动脉栓塞治疗

大咯血为肺科常见急症之一，当咯血量大于300ml／24h时，临床上称之为大咯血。其中约3％的患者虽经内科多种治疗仍不能控制，外科手术治疗同样具有较高的病死率，且并发症发生率高。我院近年来对12例顽固性大咯血患者进行了14次支气管动脉栓塞（BAE）术，取得满意疗效，现结合文献报道分析如下。

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。