中晚期中心型肺癌的综合治疗  

Multimodality treatment of central type lung cancer at intermediate stage and advanced stage

作　　者：刘江泽[1] 万兵[1] 魏嵬[1] 熊远奎[1] 刘四斌[1] 

机构地区：[1]华中科技大学同济医学院附属荆州中心医院放射科,武汉434020

出　　处：《放射学实践》2012年第12期1331-1334,共4页Radiologic Practice

摘　　要：目的:探讨支气管动脉化疗栓塞结合同步放疗、静脉化疗治疗中心型肺癌的疗效。方法:156例中晚期中心型肺癌患者分为两组,放化疗组77例,化疗与放射治疗同步进行。介入组79例,采用支气管动脉化疗栓塞,第二天行放疗,介入2个周期。放疗总剂量60～70G,6～7周完成。所有患者3～4周后采用长春瑞滨、顺铂或依托铂苷、顺铂方案,共化疗2～4个周期。结果:两组病例全部完成治疗计划。介入组CR 39.2%,PR 46.7%,有效率(CR+PR)85.9%,中位生存期为23.3个月,1、2、3年生存率为79.7%、49.4%、26.6%。对照组CR 25.9%,PR 38.9%,有效率(CR+PR)64.8%,中位生存期为15.8个月,1、2、3年生存率为63.6%、31.2%、13.0%。介入组与对照组之间疗效差异有统计学意义(P<0.05)。无严重并发症发生。结论:经支气管动脉化疗栓塞结合放疗、静脉化疗治疗中心型肺癌能延长患者的中位生存期,提高患者的生存率,具有较好的临床疗效。Objective：To evaluate the therapeutic effect of bronchial artery chemoembolization together with synchro- nous radiotherapy and intravenous chemotherapy in treating central type carcinoma of the lung. Methods： 156 patients of in- termediate stage and advanced stage central type lung cancer were divided into two groups. The chemoradiotherapy group （77patients） received concurrent chemoradiotherapy. The interventional therapy group （79 patients） received 2 courses of bronchial artery chemoembolization and then radiotherapy. The radiotherapy was accomplished within 6-7 weeks with the total accumulated dose of 60-70GY. Three to four weeks later,two to four cycles of systemic chemotherapy by using NP scheme or EP scheme were carried out. Results：Treatment plans of the two groups were all completed. The overall response rate （CR＋PR） in the interventional therapy group was 85.9% with a complete response rate （CR） of 39.2% ,partial re- sponse rate （PR） of 46.7% ,the median survival period was 23.3 months,and the 1- year,2- year and 3-year survival rates were 79.7% ,49.4%and 26.6%,respectively. The overall response rate （CR＋PR） in the control group was 64.8% with a complete response rate （CR） of 25.9 %, partial response rate （PR） of 38.9 %, the median survival period was 15.8 months, and the 1- year,2 year and 3-year survival rates were 63.6% ,31.2% and 13.0%respectively,with a significant difference existing between the interventional therapy group and the control group （P〈0.05）. No severe complications occurred. Con- clusion： Bronchial artery chemoembolization combined with radiotherapy and systemic chemotherapy is an effective treatment for the central type carcinoma of the lung. This therapy can distinctly elongate the median survival period and increase the survival rate.

关 键 词：肺肿瘤 介入治疗 化疗方案 抗肿瘤 放射治疗 

分 类 号：R734.2[医药卫生—肿瘤]