雾化吸入粒细胞-巨噬细胞集落刺激因子治疗肺转移癌的临床研究

Objective To evaluate the feasibility of granulocyte macrophage-colony stimulating factor (GM-CSF)delivery to the lung using an aerosol in patients with metastatic lung cancer to the lungs.Methods A Phase I dose escalation study inhaled GM-CSF at three dose levels as twice-a-dayx7 days schedule.Blood counts were checked at the beginning and end of each week of GM-CSF nebulization. If no toxicity was encountered,in-patients rested for 7 days and then were inhaled at the next dose level.Results Six of sevenpatients were all dose escalated from 60 μg/dose twice-a-dayx7 days,to 120μ g/dose twice-a-dayx7 days,then 240μg/dose twice-a-dayx7 days,one of the patients with cerebral hemorrhage was removed from the clinical trials,and no toxicity was seen.Comparison of inhaled GM-CSF of day 0 and day 7 blood leukocyte counts and percentage of neutrophils,it showed no significant difference in analysis of blood count data at the beginning and end of nebulization used paired t tests for each dose level.The other 9 patients received an additional 2-6 months of intermittent aerosol GM-CSF at 240 μg dose level without side effect.Two patients with bilateral lung metastases of lung adenocarcinoma had a progress disease after 2-2.5 months of aerosol GM-CSF.One patient with lung metastasis of SCLC had a progressive disease after 2 months of aerosol GM-CSF,the other 6 patients had stabilization of pulmonary metastases for 2-6 months. Conclusion Aerosol delivery of GM-CSF may achieve effective immunological antitumor action in the metastases tumor to lungs,and this therapy is feasible and possibly effective and worthy of further study.     

雾化吸入粒细胞-巨噬细胞集落刺激因子治疗肺转移癌的临床研究

目的研究雾化粒细胞-巨噬细胞集落刺激因子（GM—CSF）作用于原发于肺部肿瘤肺转移癌的药物毒性和治疗的可行性。方法采用GM—CSF三个剂量递增水平的试验设计,每日2次雾化连续7d休息7d的方案。若未观察到药物的毒性反应,休息7d后再进行下一个剂量水平的试验。结果7例患者中的6例完成60、120和240μg3个剂量水平的雾化试验。雾化GM—CSF前后白细胞数和粒细胞百分比数差异无统计学意义。另外9例患者接受240μgGM—CSF的7d雾化方案治疗2～6个月,无一例患者观察到药物的毒性反应。2例肺腺癌双肺转移和1例小细胞肺癌双肺转移,病情进展,其余6例患者病情稳定2～6个月,全部患者未发生药物的不良反应。结论雾化GM—CSF治疗原发性肺癌的肺转移,是一种耐受性较好的生物治疗,也显示出一定的抗肿瘤作用。     

肺癌脑转移放疗化疗的综合治疗

肺癌同时伴脑转移预后极差 ,单纯放疗或化疗其疗效均不理想 ,为寻求一种较理想的综合治疗方法 ,我们对 30例肺癌同时伴脑转移病人采取同时放化疗 ,现报告如下。1　临床资料1 1　一般资料　 1995年 8月至 1997年 4月我院共收治 30例肺癌同时伴脑转移病人 ,其中男性 2 1例 ,女性 9例 ,中位年龄 5 5岁 (42～ 6 8岁 )。小细胞肺癌9例 ,非小细胞肺癌 13例 ,无病理报告 8例。脑转移病灶皆由头部ＣＴ、ＭＲ证实 ,其中多发病灶 19例 ,单发病灶 11例。ＫＰＳ评分≥ 6 0分 ,肝、肾功能正常 ,血ＷＢＣ >4 0× 10 9/Ｌ ,Ｐｔ>10 0× 10 9/Ｌ。1 2　治疗…