支气管灌注化合全身化治晚期肺癌的床察.docVIP

支气管动脉灌注化疗联合全身化疗治疗中晚期肺癌的临床观察摘要目的：观察支气管动脉灌注化疗联合全身化疗治疗中晚期肺癌的疗效及安全性。方法：18例失去手术机会的中晚期肺癌患者接受支气管动脉灌注化疗2周期，28天为一周期，化疗药物为顺铂50mg/m2+比柔吡星50mg/m2+进口碘化油3ml，2周期后予GP方案（吉西他滨1.0d/m21,d8+顺铂80mg/m2d1）全身化疗两周期。按WHO标准评价疗效和毒副反应。结果：18例中CR2例，PR11例，SD3例，PD2例，总有效率为72%。主要毒副反应为骨髓抑制及消化道反应。结论：支气管动脉灌注化疗联合全身化疗是治疗中晚期肺癌的有效手段，毒副反应较轻，患者易耐受。动脉灌注化疗肺癌骨髓抑制Abstract］ objective To observe the curative effect and security of arteria bronchialis perfusion chemotherapy association generalized chemotherapy to the patients who are suffer from the advanced stage of pulmonary carcinoma.Method 18 patients who had lost the operation chance were studied. All patients first accepted 2 cycle times arteria bronchialis perfusion which was 28 days of each cycle time, DDP 50 mg/m2+THP50mg/m2+import iodized oil 3ml were used for perfusion, and then 2 cycle times generalized chemotherapy （Gemcitabine1.0/ m2d1, d8 + DDP 80mg/ m2d1）for each patients. The curative effect and adverse reaction were judged by the standard of the world health organization. Result 2 out of 18 patients showed complete response to the therapy, 11 Partial response and 3 stable disease. The total effective rate was 72%. Adverse effects included bone marrow depression and temporarily adverse reaction of digestive. Conclusion Arteria bronchialis perfusion association chemotherapy, which has slight adverse effects and easy to tolerance, can effectively treat the patients who are suffer from the advanced stage of pulmonary carcinoma. ［Keywords］arteria bronchialis perfusion; chemotherapy; pulmonary carcinoma; bone marrow depression 支气管动脉灌注化疗是治疗中晚期肺癌的有效方法之一.可以确切延长中位生存期,提高患者生存质量 ［1-2］。因中晚期肺癌大多数失去了手术机会，动脉介入治疗被广泛应用于临床，笔者采用此方法联合全身化疗获得了比较满意的效果，大部分患者临床症状明显改善，CT扫描复查示病灶明显缩小或消失，明显提高了生存质量。我院于2007年7月-2009年7月共以此方法治疗中晚期肺癌患者18例，现将结果报告如下： 1 资料与方法 1.1 临床资料 自2007年7月-2009年7月，18例中晚期肺癌患者，男性12例，女6例；中位年龄58岁（48-75岁）；临床症状主要是咳嗽、痰中带血丝、咯血、胸闷、胸痛、气短。全部病例均行影像学检查。经病理证实，鳞癌10例，腺癌7例小细胞癌1例。 1.2? 方法? 采用Seldinger法经股动脉插管选用5.0F Cobra型导管，，观察肿瘤动脉血管的分支、分布、染色浓度。确定靶血管后经导管用生理盐水稀释后缓慢注入联合抗癌药。一般选择：顺铂60-80mg