单肺隔离药物灌注并经肺动脉植入导管药泵治疗肺癌的远期疗效  

Long-term Effect of Chemotherapy of Lung Cancer by Isolated Lung Perfusion and Planted Drug Pump on Pulmonary Artery

作　　者：张春芳[1] 楼洋[1] 陈胜喜[1] 黄琼辉[1] 张恒[1] 罗万俊[1] 

机构地区：[1]中南大学湘雅医院心胸外科,长沙410008

出　　处：《中国肺癌杂志》2009年第3期227-230,共4页Chinese Journal of Lung Cancer

基　　金：人事部中国博士后科学基金(No.2004036433);湖南省科技厅科研基金(No.03ssy3065);湖南省卫生厅科研基金(No.B2004024)资助~~

摘　　要：背景与目的如何有效治疗失去手术机会的肺癌,一直是肺癌研究和治疗的重大课题。本研究旨在探讨通过单肺隔离药物灌注并经肺动脉植入导管药盒埋于皮下行肺癌局部化疗的治疗作用,并观察其远期疗效。方法建立肺隔离灌注(isolated lung perfusion,ILP),灌注完毕后将药泵埋于前胸壁皮下备用。观察组为ILP化疗并经肺动脉药泵局部肺灌注化疗51例,ILP选用阿霉素(ADM),术后经肺动脉药泵灌注化疗用GP方案。对照组采用全身静脉化疗,全组50例,采用GP方案。结果肿瘤治疗疾病控制率(CR+PR+SD):观察组78.4%,对照组56.0% (P=0.016);生存率:两组均随访5年,1年生存率观察组81.2%,对照组23.3%(P<0.001);3年生存率观察组27.5%,对照组8.0%(P=0.012);5年生存率观察组为6.0%,对照组为0(P=0.240);化疗毒副作用:观察组ILP经化疗泵肺动脉药物灌注肺癌局部化疗较全身静脉化疗组的毒副反应程度明显减轻,持续时间缩短,恢复快;生存质量:ILP组生活质量明显改善。结论肺隔离药物灌注化疗治疗肺癌是治疗晚期肺癌的一种新的有效手段,它较全身静脉化疗可极大地提高肿瘤局部的药物质量浓度,最大限度杀灭肿瘤细胞,又可减轻严重的全身毒副作用;ILP术中经肺动脉植入导管药泵埋于皮下为以后持续经肺动脉灌注局部化疗提供了便利条件,明显延长了患者的生存时间,改善了生存质量。Background and objective How to treat non-surgical lung cancer effectively is always a great subject in the research and therapy of lung cancer. The aim of this study is to study chemotherapy of lung cancer through isolated lung perfusion （ILP）, and to observe the protective efficacy. Methods After high dose of chemotherapy through circular perfusion, plant a duct into the inflicted pulmonary artery and lead the duct to a subcutaneous drug pump implanted. Study group of 51 cases was dripped through the pump with ADM, meanwhile dripped drag of GP schedule. Chemo group of 50 cases was applied intravenous GP schedule. Results Disease control rate （CR＋PR＋SD） is 78.4% in study group and 56.0% in control group （P=0.016）; Survival rate of one year is 81.2% and 23.3% （P〈0.001）, survival rate of three year is 27.5% and 8.0% （P=0.012）, and survival rate of five year is 6.0% and 0 （P=0.240） respectively; Toxin side-effect： ILP had a lesser degree of toxin side-effect, and the side-effect sustained shorter and the recovery was faster; Quality of existence： quality of life in study group was improved obviously. Conclusion ILP is a safe and feasible novelty of treating late lung cancer. The advantage is its high concentration, precise local administration and lesser side-effect; subcutaneous drug pump facilitates the intermittent local administration of drag and could clearly improve the survival rate and life quality.

关 键 词：肺肿瘤 化疗 肺隔离灌注 

分 类 号：R734.2[医药卫生—肿瘤]