支气管动脉灌注化疗联合全身静脉化疗在中央型非小细胞肺癌中的应用

背景与目的中央型非小细胞肺癌(NSCLC)诊断时多为中晚期,治疗效果欠佳,本研究分析比较中央型NSCLC经支气管动脉灌注化疗(BAI)联合全身静脉化疗与单纯全身静脉化疗的疗效,以求更为理想的治疗方法。方法回顾性分析了87例中央型NSCLC患者的近期疗效和远期疗效。患者分为BAI化疗联合全身静脉化疗组与单纯全身静脉化疗组。结果联合治疗组和对照组有效率(RR)分别为61.76%和24.52%(P=0.001);临床受益率(CBR)分别为88.23%和83.01%(P=0.721);中位疾病进展时间(TTP)分别为4.4个月和4个月(P=0.04);1年存活率分别为38.23%和39.62%,中位生存时间(MST)分别为10.9和11.1个月,两组生存曲线之间比较,联合治疗组与对照组无明显差异(P=0.977)。联合治疗组与对照组在血液学及非血液学毒性反应方面无统计学差异。结论BAI化疗联合全身静脉化疗能明显提高中央型NSCLC患者的有效率,安全性好,远期疗效与全身静脉化疗组相当,值得进一步推广。

The Application of Bronchial Arterial Infusion plus Vein Chemotherapy in the Treatment of Advanced Central NSCLC

Background and objective Many patients were not in early stage when they were diagnosed with central NSCLC. The therapeutic effect of advanced lung-cancer was very poor. The aim of this study is to compare therapeutic effect between bronchial arterial infusion （BA1） plus vein chemotherapy and traditional vein chemotherapy, and find a better way to treat advanced central NSCLC. Methods Eighty-seven patients with advanced central NSCLC were reviewed. They were treated by BAI plus vein chemotherapy or traditional vein chemotherapy. This study analyzed retrospectively the response rate, clinical benefit rate, time to progression, 1-year survival rate, median survival time and safety. Results Response rate was 61.76% in trial group and 24.52% in control group（P=0.001）.The clinical benefit rate was 88.23% in trial group and 83.01% in control group（P=0.721）.The median TTP was 4.4 months in trial group and 4 months in control group（P=0.04）.l-year survival rate was 38.23% in trial group and 39.62% in control group. The median survival time was 10.9 months and 11.1 months in control group, respectively. The comparison of survival curve between two groups showed no remarkable differences. （P=0.977）.There were no significant differences in incidence of hematologic and non-hematologic toxicity between two groups. Conclusion BAI plus vein chemotherapy for advanced central NSCLC patients shows a better efficacy and a favorable toxic profile. There is no remarkable differences between two groups in survival. It is worthy of further clinical studies.