支气管动脉灌注化疗与超选择栓塞化疗治疗肺癌的临床对比

目的探讨支气管动脉灌注化疗和栓塞化疗治疗肺癌的临床效果。方法回顾分析199例经病理学诊断的肺癌行超选择性支气管动脉栓塞化疗和支气管动脉灌注化疗的患者。超选择性支气管动脉栓塞化疗75例,普通导管插管造影后,将导管或微导管超选择性插至肿瘤供血动脉近端,经微导管注入抗癌药及抗癌药超液态碘油混悬乳剂,再用明胶海绵颗粒栓塞肿瘤供血动脉。支气管动脉灌注化疗124例,普通导管插至支气管动脉主干造影证实后,经导管注入抗癌药。结果75例超选择性支气管动脉栓塞化疗者,完全缓解(CR)19例,部分缓解(PR)41例,稳定(SD)11例,进展(PD)4例,有效率为80.0%;0.5、1.0、2.0年生存率分别为92.0%、78.7%、69.3%。124例支气管动脉灌注化疗者,CR21例,PR55例,SD30例,PD18例,有效率(CR+PR)为61.3%;其0.5、1.0、2.0年生存率分别为87.9%、60.5%、46.8%。两组有效率及1年和2年生存率均具有非常显著性差异(P<0.01)。结论超选择性支气管动脉栓塞化疗治疗肺癌安全有效且其疗效明显优于支气管动脉灌注化疗。

A clinical study on the treatment of central lung cancer with bronchial arterial infusion and superselective chemoembolization

Objective To study the therapeutic effects of superselective bronchial arterial chemoembolization （BACE） and bronchial arterial infusion （BAI）on lung cancer. Methods The 199 patients with lung cancer pathologically proved were studied. Bronchial artery infusion was performed in 124 patients. Anticancer drugs were infused through the catheter which was placed in the bronchial artery trunk after angiography, Superselective bronchial artery ehemoembolization was performed in 75 patients. Catheter or microcatheter was superselectively inserted into the distal of tumor-feeding artery after selective angiography, After anticancer drugs were infused, embolization with the emulsion of anticancer drugs and lipiodol was performed, tumor-feeding branch was also embolized with gelfoam particles at last. Results 21 cases in 124 cases performed with simply bronchial infusion got complete response（CR）, meanwhile,partial response（PR） in 55 cases,stable disease（SD） in 30 cases,and progressive disease （PD） in 18 cases.The effective rate （CR＋PR） was 61,3%, survival rate of 6,12,24 months was 87.9%, 60,5%, 46.8%respectively. In the 75 cases performed with superselective bronchial artery chemoembolization there were 19 cases of CR, 41 cases of PR, 11 cases of SD, and 4 cases of PD. The effective rate （CR＋PR）was 80.0%,survival rate of 6,12,24 months was 92.0%, 78,7%, 69.3% respectively. There were significant statistic differences in the effective rate and survival rate of 12 months and 24 months between the two methods （P〈0.01）. Conclusion BACE is safe and effective for the treatment of lung cancer and its effects are better than that of BAI.