支气管肺动脉灌注+栓塞化疗同步三维适形放疗治疗进展期中央型非小细胞肺癌的临床研究  

A clinical study on bronchial and pulmonary artery perfusion/embolism chemotherapy concurrently combined with three-dimensional conformal radiotherapy in the treatment of advanced central non-small cell lung cancer

作　　者：矫德馨[1] 贾鉴慧 张旭[1] 

机构地区：[1]辽宁省肿瘤医院放疗二科,辽宁沈阳110042

出　　处：《实用医院临床杂志》2015年第2期40-44,共5页Practical Journal of Clinical Medicine

摘　　要：目的探讨支气管肺动脉灌注+栓塞化疗同步三维适形放疗(3DCRT)治疗进展期中央型非小细胞癌肺癌(nonsmall cell lung cancer,NSCLC)的临床疗效。方法本院2011年1月至2012年2月间收治的进展期中央型NSCLC患者85例,按随机数字表法分为观察组(44例)和对照组(41例)。观察组采用支气管肺动脉灌注+栓塞同步3DCRT治疗方案,对照组采用常规静脉用药同步3DCRT方案。治疗期间记录药物毒性反应,比较治疗结束2个月后两组临床疗效、生存质量与2年生存率。结果 1治疗结束后2个月,观察组功能状态(KPS)评分、总有效率均高于对照组,差异有统计学意义(P<0.01)。2观察组同步放化疗后骨髓抑制、消化道反应、末梢神经炎、肝功能损害、肾功能损害发生率均低于对照组,而化疗后胸部疼痛发生率明显高于对照组,差异有统计学意义(P<0.05)。3观察组治疗后2年内生存时间(月)明显长于对照组,差异有统计学意义(P<0.05)。结论与常规同步放化疗比较,支气管肺动脉灌注+栓塞性化疗同步3DCRT放疗能在不增加化疗药物剂量前提下提高近期疗效与生存质量,延长患者生存时间,一定程度减轻药物毒性反应。Objective To explore the clinical efficacy of bronchial and pulmonary artery perfusion plus embolism chemotherapy concurrently combined with three dimensional conformal radiotherapy（ 3DCRT） in the treatment of advanced central non small cell lung cancer（ NSCLC）. Methods Eight-five NSCLC patients from Jan. 2011 to Feb. 2012 in our hospital were enrolled in the study,and were randomized divided into observer group（ n = 44） and control group（ n = 41）. The observer group was treated with the bronchial pulmonary artery perfusion / embolism chemotherapy synchronously combined with the 3DCRT treatment while the control group was treated with a routine intravenous chemotherapy and 3DCRT treatment. The drug toxicity during treatment was recorded. The clinical efficacy,life quality（ KPS score） after 2 months of the treatment and survival rate after 2 years of treatment were compared between the two groups. Results （1）The KPS score and total effective rate after 2 months of treatment in the observation group were all significantly higher than that in the control group（ P〈0. 01）.（ 2）The incidence of bone marrow suppression,gastrointestinal reactions,peripheral neuritis,liver damage,and renal damage in the observation group were lower than that in the control group while the incidence of chest pain after chemotherapy in the observation group was significantly higher than that in the control group（ P〈0. 05）.（ 3）The mean survival time within 2 years in the observation group was significantly longer than that in the control group（ P〈0. 05）. Conclusion Compared with the conventional synchronous chemotherapy and radiotherapy,the bronchial pulmonary artery perfusion / embolism chemotherapy synchronously combined with 3DCRT treatment can improve the clinical efficacy and survival quality,prolong the survival time,and reduce the drug toxicities to a certain extent on the premise of not increasing drug dose.

关 键 词：中央型非小细胞癌肺癌 肺动脉灌注 栓塞 三维适形放疗 生存质量 生存率 

分 类 号：R734.2[医药卫生—肿瘤]