肺癌脑转移动脉内化疗中甘露醇的应用价值研究  

An Applied Study of the Intraarterial Chemotherepy with Mannitol for Brain Matastasis Tumor of Lung Cancer

作　　者：陶晓峰[1] 肖湘生[1] 韩希年[1] 施增儒[1] 

机构地区：[1]第二军医大学附属长征医院影像科,上海200003

出　　处：《实用放射学杂志》2000年第7期387-390,共4页Journal of Practical Radiology

基　　金：国家自然科学基金!资助项目 (编号 36970 2 31 )

摘　　要：目的 :进一步了解和认识甘露醇开放血脑屏障 ,对肺癌脑转移瘤动脉内化疗的应用价值。方法 :15例病人 ,男 11例 ,女4例。年龄 37～ 71岁 ,平均 5 2 .5岁。所有病人 ,均为肺腺癌。随机分为二组 ,甘露醇组 8例 ;非甘露醇组 7例。采用 Seldinger插管技术 ,经股动脉插管 ,将导管送到病变侧的颈内动脉或一侧椎动脉。部分病人到眼动脉水平以上 ,进行超选化疗。化疗药使用 VM-2 6。剂量为 15 0 mg/人 /次。每次化疗间隔 3～ 5周。甘露醇组 ,化疗前给予 2 0 %甘露醇 2 0 0～ 2 5 0 ml。结果 :(1)疗效。甘露醇组和非甘露醇组的比较 ,前者完全缓解 1例 ,部分缓解 2例 ,稳定 3例 ,病变进展 2例 ,有效率为 75 % (6 / 8)。后者完全缓解 1例 ,部分缓解 1例 ,稳定 3例 ,病变进展 2例。有效率为 71.4% (5 / 7)。统计结果 :两者疗效无统计学差异 ,相差不显著。 (2 )并发症 ,经颈内动脉灌注甘露醇时 ,多数病人同侧眼眶有烧灼感 ,2例化疗后白细胞曾低于 1.5× 10 1 2 / L。个别病人有短暂的恶心、呕吐现象。脱发常见。结论 :(1)动脉插管介入化疗 ,对于治疗脑内转移性肿瘤具有较好的疗效。安全、可靠。 (2 )甘露醇对脂溶性化疗药物 (VM- 2 6 )的脑内转移瘤疗效作用不大。Objective:To evaluate the applied value of mannitol opening blood brain barrier to the intraarterial chemotherapy of brain matastasis neoplasm of lung cancer.Methods:There were 15 cases,11 men and 4 women.Age ranged from 27 to 71 years,mean 52.5 years.All cases were proved as lung adenocarcinoma and divided into two groups at random,a mannitol group was 8 and a non-mannitol group was 7.Using Seldinger technique and femoral route,catheterization of internal carotid artery or veterbral artery was performed followed by VM-26 chemoterapy,the dose of VM-26 was 150 mg in one time.For mannitol group,250 ml 20% mannitol was injected quickly into artery before chemotherapy.Results:1.Therapy efficacy.In mannitiol group,complete response occured in 1 case,partial response in 2 cases,stable disease in 3 cases,progressive disease in 2 case,total effective rates was 75%.In non-mannitol group,complete response occured in 1 case,partial response in 1 case,stable disease in 3 cases,progressive disease in 2 cases,total effective rates was 71.4%.Curative effect of both of mannitol groups and non-mannitol group had no statistics difference.2.Complications,most of cases felt slight borning in eye′s area while were injected of mannitol.White blood cell droped down at 1.5×10 12 /L in two cases.Some cases had temporal nause and vomiting.Hair losing was much more offen found.Conclusion:1.The study proves that intraarterial chemotherapy is a considiable effective and safe method of treating brain matastasis tumor of lung cancer.2.There are no certain significance that mannitol affect the curative effect in treating brain tumor with lipophilic anti-tumor compounds. [

关 键 词：脑转移瘤 甘露醇 肺肿瘤 动脉内化疗 

分 类 号：R734.206[医药卫生—肿瘤] R739.410.5[医药卫生—临床医学]