肺癌选择性支气管动脉灌注化疗的临床分析

目的：探讨选择性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６９例中晚期肺癌进行ＢＡＩ治疗，根据不同病期、组织类型、病变部位、肿瘤血管构型、血供类型及操作技术进行分析。结果：（１）中央型，小细胞未分化癌及鳞癌、多血管构型、少血供者与周围型、腺癌、少血管构型、多血供患者之间疗效差异有显著性，前者优于后者（Ｐ＜０．０５）。（２）６９例中ＢＡＩ后肺内局部病变完全缓解（ＣＲ）１５例（２１７％），部分缓解（ＰＲ）３２例（４６４％），缓解（ＣＲ＋ＰＲ）４７例，缓解率６８１％。其中小细胞未分化癌、鳞癌、腺癌的缓解率分别为９３２％、７９４％、５１５％。结论：（１）Ⅳ期病人不适合ＢＡＩ治疗。（２）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，几次ＢＡＩ治疗中间或之后，配合全身化疗或放疗，治疗或消灭远处转移。

CLINICAL ANALYSIS OF SELECTIVE BRONCHIAL ARTERY INFUSION AND CHEMOTHERAPY OF LUNG CANCER

Objective:To study the effect of selective bronchial artery infusion and chemotherapy in the treatment of patients with intermediate and advanced stages of lung cancer.Methods:According to TNM stages,fissue typs,vascular structure,feeding artery,69 cases of advanced lung cancer patients were treated by BAI.Results:1.The effect of treatment was good in patients of lung cancer of central type,or small cell undifferentiated lung carcinomas or squamous cell carcinomas,or hypervascular structuers and few feeding artery types.2.In 67 cases,CR was 13 cases (21.7%),PR was 32 cases (46.4%).Bone metastasis was accured in 16 cases.Cerebral metastasis was accured in 14 cases.Conclusion:1.BAI was not fit for patients of the forth stage lung cancer.2.The best effect of treatment by BAI would be gained in pantent of squamous cell carcinomas.3.Small cell undiffeventiated lung carcinomas shoud be treated by systemic chemotherapy and BAI.