肺癌组织内通读通读动脉灌注血管立体构筑

目的：为探讨肺癌介入治疗宜采用的动脉，研究肺癌组织内肺动脉的立体构筑。方法：５例手术切除肺癌标本应用１０％ＡＢＳ丙液从肺动脉高压灌注进行肿瘤篾这铸型，并在立体显微镜下观察肺癌组织肺动脉立体构筑。７８例支气管动脉造影资料进行回顾性分析。光学显微镜下观察肺癌组织内毛细血管床。结果：按动脉分布，肺癌组织可分炎三个不同区带：支气管动脉主要供应肺癌的中心区；吕外带肺动脉相对密集，呈向心直行并互相吻合；癌周组     

动脉灌注化疗加静滴VP－16治疗95例中晚期肺癌的疗效观察

动脉灌注化疗加静滴ＶＰ－１６治疗９５例中晚期肺癌的疗效观察席晓秋，段天红四川省肿瘤医院影像科（成都市６１００４１）近年来选择性支气管动脉灌注化疗（ＢＡＩ）治疗中晚期肺癌在国内发展较快，取得了肯定的近期疗效。但临床观察到ＢＡＩ对转移灶的控制不理想，且在...     

双重动脉药物灌注治疗中晚期非小细胞型肺癌：附10例报告

经选择性支气管动脉灌注（ＢＡＩ）和经肺动脉药物灌注（ＰＡＩ）治疗中晚期非小细胞型肺癌１０例，共４２例次，近期有效率达８０％，使５例获得手术治疗机会。全组中位生存期１１．５个月。作者对双重动脉药物灌注的机理，疗效进行了分析，指出ＤＡＩ可以使高浓度化疗药物充分与肺肿瘤细胞接触，发挥最佳疗效。对ＢＡＩ插管困难或支气管动脉无优势供血的肺肿瘤，可经ＰＡＩ增强疗效，ＤＡＩ治疗减少了ＢＡＩ的次数并可减少由ＢＡＩ引起的并发症。     

经留置导管支气管动脉内灌注治疗非小细胞肺癌(附68例报告)

目的：主人经留置导管支气管动脉内交替灌注化疗药物臁细胞因子治疗中晚期非小细胞肺癌（ＮＳＣＬＣ）的疗效。方法：６８例经病理学证实的ＮＳＣＬＣ患者随机分为Ａ、Ｂ两组,分别进行经留置导管支气管动脉内交替灌注化疗药物及细胞因子和单纯支气管动脉灌注化疗３￣４次。结果：Ａ、Ｂ两组的近期有效率分别为９１．１８％和４４．１２％,两者具有显著性差异,无严重并发症。结论：留置导管及细胞因子与ＢＡＩ的有机配合,为中晚期     

经支气管动脉灌注治疗肺癌对肺换气功能的影响

经支气管动脉灌注治疗肺癌对肺换气功能的影响顾月清蔡俊鲁顺德顾小萍丁福琴石根妹主题词肺肿瘤／药物疗法动脉灌注换气功能中图号Ｒ７３４．２Ｒ７３０．５３经支气管动脉灌注（ＢＡＩ）化疗药物治疗原发性支气管肺癌已有许多报道，但有关ＢＡＩ化疗对患者的肺功能和动脉...     

免疫因子癌灶注射联合动脉灌注化疗双介入治疗晚期肺癌

目的 评价免疫因子癌灶注射联合支气管动脉灌注化疗双介入治疗晚期肺癌的临床价值，材料一方法 对１７例失去手术机会的晚期肺癌采用双介入疗法，即经纤维支气管镜或经皮直接穿刺癌灶局部注射免疫因子联合支气管动脉灌注化疗（ＢＡＩ）治疗，并与１６例同期单作ＢＡＩ治疗肺癌病例中效对照研究。结果 双介和 安全缓解（ＣＲ）２例，部分缓解（ＰＲ）１３例，近期显效率（ＣＲ＋ＰＲ）为８３．２３％，明显优于单纯ＢＡＩ的ＣＲ＋     

肺癌支气管动脉灌注化疗后并发食管支气管瘘的防治：附四例报告

肺癌支气管动脉灌注化疗后并发食管支气管瘘的防治（附四例报告）浙江省人民医院心胸外科孔颂阳，许林海，钱文伟，程颖浙江省人民医院放射科（３１００１４）刘子江肺癌支气管动脉灌注（ＢＡＩ）化疗后并发食管支气管瘘，近年来陆续有报道［１，２］。如诊治不及时，其死...     

介入治疗中晚期肺癌30例疗效分析

介入治疗中晚期肺癌３０例疗效分析浙江省德清县第一医院呼吸科（３１３２００）浙江省德清县第一医院肿瘤科（３１３２００）俞计明，翁方纪本院从１９９３年５月～１９９５年１１月对３０例中晚期肺癌进行选择性支气管动脉灌注化疗（ＢＡＩ）加选择性支气管动脉栓塞术（...     

锁骨下动脉灌注化疗对肺癌的疗效观察

锁骨下动脉灌注化疗对肺癌的疗效观察浙江省人民医院介入治疗科（３１００１４）贾勇士，刘子江，袁建华，瞿幼存近年来，支气管动脉灌注化疗（ＢＡＩ）治疗中、晚期肺癌在临床上应用广泛，已取得较好效果［１］。但对部分患者尤其是肿块位于肺上叶中央型或周围型的肺癌患...     

羟基喜树碱双重动脉灌注治疗支气管肺癌的临床研究

从１９９４年１０月以来，对１２例不能手术的肺癌患者进行了ＢＡＩ和肺动脉灌注（ＰＡＩ），羟基喜树碱及化疗药物的双重动脉灌注（ＤＡＩ）对照研究，取得了满意疗效。１　材料与方法１１　临床资料１１１　病例选择　观察组为中晚期肺癌门诊及住院患者１２例，年龄４３～６８岁，平均５６岁；男１１例女１例。中心型８例，周围型３例，细支气管肺泡癌１例。对照组为本院以前作的单纯ＢＡＩ灌注化疗药物２０例，年龄３６～６８岁，平均５６岁；男１８例，女２例。中心型１３例，周围型７例。两组年龄及性别无显著性差异，具有可比性…     

Effective use of multi-arterial infusion chemotherapy for advanced non-small cell lung cancer patients: four clinical specified cases

Arterial infusion chemotherapy is considered to be a treatment option for lung cancer patients who are intolerant of systemic chemotherapy because of an increased risk of severe toxicity. However, a number of major studies regarding arterial infusion chemotherapy for lung cancer have reported disappointing results. We performed arterial infusion chemotherapy for four patients with advanced NSCLC who were unable to receive systemic chemotherapy or radiotherapy. After detecting the feeding arteries precisely by angiography, low-dose chemotherapeutic agents were administrated into the corresponding arteries. In each case, multiple feeding arteries including main feeding arteries other than the bronchial artery were detected and a partial response (PR) was obtained without severe toxicity in all. We consider that the present method is an effective treatment option for lung cancer patients who are restricted from undergoing standard systemic chemotherapy or radiotherapy.     

Multi-arterial infusion chemotherapy for non-small cell lung carcinoma--significance of detecting feeding arteries and tumor staining

The present study examines the significance of defining feeding arteries to arterial infusion chemotherapy for patients with non-small cell lung carcinoma. We retrospectively studied feeding arteries and findings from 32 patients treated by arterial infusion chemotherapy. We graded tumor staining by angiography and compared grade in the bronchial artery with that of total staining in all detected feeding arteries, and investigated the relationship between grade and treatment response. One patient achieved a complete response and 16 achieved a partial response with no serious adverse effects. Many feeding arteries were detected and the grade of total tumor staining in these patients was significantly higher than that of tumor staining in the bronchial artery. The number of lesions that responded was significantly increased among those with a higher grade of total tumor staining. Precise definition of feeding arteries and sufficient tumor staining are vital to ensure a successful outcome of arterial infusion chemotherapy for patients with NSCLC.     

Pulmonary arterial infusion therapy for lung metastasis of colorectal cancer

We have developed a pulmonary arterial infusion therapy for lung metastasis of colorectal cancer. Catheterization into pulmonary artery followed by occlusion with ballooning enabled the stasis of blood flow in the unilateral lung for 30 minutes. CDDP was infused via catheter to occluded pulmonary artery. Although no serious adverse events occurred in 5 cases, a tumor reduction in size was not observed. Loco-regional therapy for lung metastasis of colorectal cancer is limited because of recent progress of systemic therapy. However, a development of the procedure of pulmonary arterial infusion may enable a future success of local therapy for lung metastasis of colorectal cancer with a new drug, which is effective in such a short time disposure to tumor as 30 minutes.     

Clinical benefit of bronchial arterial infusion chemotherapy to pulmonary metastasis from colorectal cancer--report of two cases

Case 1: A 60-year-old woman with sigmoid colon cancer and multiple lung metastases developed dyspnea 34 months after sigmoidectomy and following systemic chemotherapy. Chest X-ray revealed left atelectasis and obstruction of the left main bronchus by lung metastasis, and stenosis of the right main bronchus was also suspected. Bronchial arterial infusion of CDDP, 5-FU and MMC relieved the atelectasis and dyspnea. The left bronchus remained patent for 12 months. Case 2: A 70-year-old man who had a pulmonary recurrence of rectal cancer suffered from hemoptysis and dyspnea, which had improved with systemic chemotherapy but then become exacerbated again. Bronchoscopic examination revealed intraluminal bleeding from a metastatic tumor. The symptoms were relieved after bronchial arterial infusion of CDDP, 5-FU and MMC. The diameter of the treated tumor was reduced by 15%. Hemoptysis was negligible until he died 8 months later. Bronchial arterial infusion chemotherapy for pulmonary metastasis from colorectal cancer is clinically beneficial, especially for patients with life-threatening respiratory symptoms like airway obstruction or intraluminal bleeding.     

Novel chemoradiotherapy for locally advanced pancreatic cancer using arterial infusion chemotherapy following the alteration of peripancreatic blood flow

Radiotherapy employing intraoperative radiation therapy (IORT) in combination with postoperative external beam radiation therapy (EBRT) is an effective treatment for unresectable pancreatic cancer. To achieve an even greater therapeutic outcome, 13 patients with unresectable pancreatic cancer were treated by IORT in combination with EBRT plus locally intensive arterial infusion chemotherapy. In order to increase drug delivery to the primary tumor, the splenic and major pancreatic arteries, except for the gastroduodenal artery (GDA), were embolized by radiological intervention prior to the arterial infusion chemotherapy, and the administration of gemcitabine, CDDP, and 5-FU to the primary tumors via GDA was followed during EBRT. The values of serum tumor markers were decreased in all patients, and tumor regression was detected on CT scans in 6 patients. The evaluation of survival benefit of this treatment modality is ongoing, but it did not prolong the survival time of patients with second stage lymph node metastases. One of the advantages of this method was able to perform also in charge of hepatic arterial infusion chemotherapy concurrently, but we experienced liver abscess in 2 patients.     

INVESTIGATION OF BLOOD SUPPLY OF BRONCHOGENIC CARCINOMA DERIVING FROM PULMONARY ARTERY

ＩＮＶＥＳＴＩＧＡＴＩＯＮＯＦＢＬＯＯＤＳＵＰＰＬＹＯＦＢＲＯＮＣＨＯＧＥＮＩＣＣＡＲＣＩＮＯＭＡＤＥＲＩＶＩＮＧＦＲＯＭＰＵＬＭＯＮＡＲＹＡＲＴＥＲＹＺｈｅｎｇＲｕｈｅｎｇ郑如恒ＤｏｎｇＹｏｎｇｈｕａ董永华ＺｈｏｕＫａｎｇｒｏｎｇ周康荣（Ｄｅｐａｒ...     

CAP方案不同用药途径治疗非小细胞肺癌疗效比较

目的：比较ＣＡＰ方案经支气管动脉灌注与外周静脉用药治疗非小细胞肺癌的疗效。方法：４５例患随机分为Ａ、Ｂ两组,均用ＣＡＰ方案治疗,Ａ组经支气管动脉灌注用药,Ｂ组经外周静脉用药,均治疗３个疗程。结果：Ａ组ＣＲ１４．３％,ＰＲ５７．１％,Ｂ组ＣＲ为Ｏ,ＰＲ３７．５％,毒副反应：Ａ组的Ⅱ～Ⅲ度骨髓抑制及消化道反应均低于Ｂ组（Ｐ〈０．０５）。结论：ＣＡＰ方案治疗非小细胞肺癌经支气管动脉灌注疗效优于经外周静     

双重动脉灌注化疗治疗转移性肺癌的疗效探讨

目的探讨支气管动脉灌注(BAI)和肺动脉灌注(PAI)相结合的双重动脉灌注(DAI)化疗对转移性肺癌的治疗效果。方法选择40例转移性肺癌为研究对象，其中采用DAI化疗的20例作观察组，单纯BAI化疗的20例为对照组，两组进行对比观察。结果观察组有效率为45％，生活质量改善率为65％；对照组分别为20％、30％。结论DAI化疗，效果优于单纯BAI化疗，是目前治疗转移性肺癌较为理想的方法。     

转铁蛋白受体单克隆抗体偶联物动脉灌注法治疗晚期肺癌

为了观察转铁蛋白受体单抗偶联物对晚期肺癌的疗效，采用转铁蛋白受体单克隆抗体与表阿霉素、顺铂等化学药物制成偶联物，对３８例中晚期肺癌进行选择性支气管动脉插管灌注，结果：ＣＲ１２例，占３１．６％，ＰＲ１７例，占４４．７％，ＮＣ７例，占１８．４％，ＰＤ２例，占５．３％，总有效率（ＣＲ＋ＰＲ）为７６．３％。通过病例观察，支气管动脉插管导向灌注疗法比单纯化疗药物动脉灌注的疗效为优，且副作用小，为中晚期肺癌的姑息治疗提供了新的有效方法     

肺癌支气管动脉与肺动脉CT血管造影分析

目的利用CT血管造影（CTA）显示支气管动脉（BA）和肺动脉（PA）三维影像学特征,进一步探讨肺癌血供。方法收集原发性肺癌147例及正常对照46例,采用多层螺旋CT胸部增强扫描获得原始图像,用容积显示（VR）、多平面重建（MPR）、最大强度投影（MIP）进行CTA重建,观察和分析BA、PA形态学特征及其与肺癌关系。结果肺癌组BA在VR中清晰显示136例,显示率为92．5％,平均2．3支／例;对照组BA清晰显示32例,显示率为69．6％,平均2．0支／例。肺癌组同侧BA管径较肺癌对侧和正常对照组BA明显增粗（P〈0．05）;肺癌同侧总截面积显著大于正常对照组（P〈0．05）,且较肺癌对侧明显增加（P〈0．05）;肺癌侧BA扩张扭曲呈蚓状走向肿瘤或进入肿瘤内,多分支网状吻合。肺癌组PA均清晰显示,54例PA穿过肿瘤或从瘤旁经过,未见异常变化;25例PA显影完整,受肿块推挤并从周围包绕肿块,形成手握球征;40例PA基本完整,肿块从外对PA环状包埋,PA管腔呈扁平状、偏心性或向心性缩窄或枯树枝征;28例PA受肿块包绕并残缺截断形成残根征。结论原发性肺癌BA明显扩张,总供血量明显增加;PA穿过肿瘤或狭窄截断。多重螺旋CTA同样证明肺癌主要为BA供血,未见PA供血证据。