单中心微导管超选择性动脉灌注化疗治疗肺癌脑转移的中远期疗效分析  

Efficacy of microcatheter superselective arterial infusion chemotherapy on primary lung cancer with brain metastases in a single center

作　　者：任敬[1] 陈谦[2] 章浩 许建新[1] 杨新宇[3] 郭再玉[2] REN Jing;CHEN Qian;ZHANG Hao;XU Jian-xin;YANG Xin-yu;GUO Zai-yu(Department of Respiratory Medicine,Tianjin TEDA Hospital,Tianjin 300457,China)

机构地区：[1]天津市泰达医院呼吸内科,天津300457 [2]天津市泰达医院神经外科,天津300457 [3]天津医科大学总医院神经外科,天津300052

出　　处：《广东医学》2019年第21期3006-3010,共5页Guangdong Medical Journal

基　　金：天津市滨海新区卫生计生委科技项目(编号:2015BWKZ005)

摘　　要：目的探讨微导管超选择性动脉灌注化疗治疗原发性肺癌合并颅内转移瘤的效果。方法对64例原发性肺癌合并颅内转移瘤的患者同期手术进行微导管超选择性动脉灌注化疗同时治疗肺部原发病灶和颅内转移瘤,所有患者都完成两次动脉灌注化疗,疗程结束后1个月评估近期疗效和耐受情况,并对患者的中远期生存情况进行随访和分析,随访时间截止到2018年12月。结果短期疗效显示完全缓解17例(26.6%),部分缓解25例(39.1%),疾病稳定14例(21.9%)。客观有效率为65.6%(42/64);疾病控制率为87.5%(56/64),中位生存期为10个月,6个月和12个月总生存率分别为90.63%(58/64)和37.35%(24/64)。年龄<60岁、转移瘤最大径<3 cm和治疗前KPS评分≥70分的患者经过动脉灌注化疗后预后较佳(P<0.05)。结论微导管超选择性动脉内灌注化疗治疗肺癌合并颅内转移瘤是一种安全的方式,可以单独或联合其他治疗方式应用以提高患者生存质量和生存期。患者年龄、转移瘤大小和治疗前KPS评分可以作为肺癌合并颅内转移的预后评价参数。Objective To investigate the efficacy of superselective arterial infusion chemotherapy with microcatheter on the treatment of primary lung cancer with intracranial metastases.Methods Sixty-four patients who suffered from primary lung cancer with brain metastases were treated with microcatheter superselective arterial infusion chemotherapy(AICT)combined with treatment of primary lung lesions and brain metastases.All patients were accomplished with two courses of arterial infusion chemotherapy.The efficacy and side effects were evaluated one month after the treatment.The medium and long term survival of the patients were analyzed.Follow-up of 64 patients were continued until December 2018.Results Short-term efficacy showed complete remission in 17 cases(26.6%),partial remission in 25 cases(39.1%)and stable disease in 14 cases(21.9%).The overall response rate was 65.6%(42/64)and the disease control rate was 87.5%(56/64).The median survival was 10 months.The overall survival rates of 6 months and 12 months were 90.63%(58/64)and 37.35%(24/64),respectively.Patients younger than 60 years old,metastases diameter less than 3 cm and KPS scores greater than 70 before treatment had better prognosis after intra-arterial chemotherapy(P<0.05).Conclusion Microcatheter superselective arterial infusion chemotherapy is a safe method for the treatment of lung cancer with brain metastases.Age,size of metastasis and KPS score before treatment can be used as prognostic parameters for lung cancer with intracranial metastasis.

关 键 词：肺癌 动脉灌注化疗 颅内转移瘤 微导管超选 生存质量 

分 类 号：R734.2[医药卫生—肿瘤] R739.41[医药卫生—临床医学]