CAJ | 학술논문

目的评价经支气管动脉灌注(BAI)治疗中心型非小细胞肺癌(NSCLC)的价值.方法 58例影像学判断手术切除难度较大或不能手术切除的中心型NSCLC患者行BAI治疗,其中鳞癌51例,腺癌6例,腺鳞癌1例.BAI前临床分期为Ⅱb期3例,Ⅲa期26例,Ⅲb期29例.结果 BAI后,31例患者获得根治性手术切除机会.未行手术切除的27例患者中,8例行放射治疗,2例行放化疗,1例行全身化疗,其余16例仅对症支持治疗.BAI总有效率为43.1%.58例患者中,53例患者BAI后发生Ⅰ、Ⅱ度胃肠道反应,24例患者出现低热.58例患者的中位生存时间为29.1个月.BAI后行根治性切除患者的中位生存时间为65.2个月,而未行手术切除者的中位生存时间为15.9个月,二者之间差异有统计学意义(P＜0.001).Ⅲa期患者中位生存时间为39.0个月,Ⅲb期患者中位生存时间为20.4个月,差异有统计学意义(P=0.042).结论 BAI用于治疗估计手术切除有困难、不伴有远处转移的中心型NSCLC疗效确切.
목적 평개경지기관동맥관주(BAI)치료중심형비소세포폐암(NSCLC)적개치.방법 58례영상학판단수술절제난도교대혹불능수술절제적중심형NSCLC환자행BAI치료,기중린암51례,선암6례,선린암1례.BAI전림상분기위Ⅱb기3례,Ⅲa기26례,Ⅲb기29례.결과 BAI후,31례환자획득근치성수술절제궤회.미행수술절제적27례환자중,8례행방사치료,2례행방화료,1례행전신화료,기여16례부대증지지치료.BAI총유효솔위43.1%.58례환자중,53례환자BAI후발생Ⅰ、Ⅱ도위장도반응,24례환자출현저열.58례환자적중위생존시간위29.1개월.BAI후행근치성절제환자적중위생존시간위65.2개월,이미행수술절제자적중위생존시간위15.9개월,이자지간차이유통계학의의(P＜0.001).Ⅲa기환자중위생존시간위39.0개월,Ⅲb기환자중위생존시간위20.4개월,차이유통계학의의(P=0.042).결론 BAI용우치료고계수술절제유곤난、불반유원처전이적중심형NSCLC료효학절.
Objective To evaluate the long-term efficacy of bronchial arterial infusion (BAI)chemotherapy in the treatment of centeral non-small cell lung cancer.Methods Fifty-eight patients with central non-small-cell lung cancer, who were assessed as difficult operable or non-operable by imaging examination, received BAI of cisplatin, epirubicin and mitomycin alone or in combination.It includes 51cases of squamous cell carcinoma, 6 cases of adenocarcinoma and 1 case of adenosquamous carcinoma.The cinical stage before BAI was Ⅱ b in 3 cases, Ⅲa in 26 cases and Ⅲb in 29 cases.Long term follow-up was conducted and the results were statistically analyzed.Results The total effective rate of BAI was 43.1%.The mediam survival (MS) of all 58 patients was 29.1 months.31 patients after BAI became operable and were rasected, had a median survival of 65.2 months.27 patients after BAI were not resected and had a MS of 15.9 months.There was a significant difference between the patients who had been resected and not.The MS of Ⅲ a stage patients was 39.0 months, and Ⅲ b stage 20.4 months.Conclusion Bronchial arterial infusion chemotherapy is a better choice with a definite efficacy for treatment of center-based NSCLC patients, estimated as difficult operable but without distant metastasis.