光动力联合化疗治疗肺癌致中心气道狭窄的效果  

The effect of chemotherapy combined with photodynamic therapy on treating central airway stenosis caused by lung cancer

作　　者：牛建明[1] 赵晨茜 张旭宇[1] 赵薇[1] 张丹[1] 李润浦 NIU Jian-ming;ZHAO Chen-xi;ZHANG Xu-yu;ZHAO Wei;ZHANG Dan;LI Run-pu(DepartnentⅡof Respiratory and Critical Medicine,Baoding Second Central Hospital,Baoding 072750,Hebei,China)

机构地区：[1]保定市第二中心医院呼吸与危重症医学二科,河北保定072750

出　　处：《广东医学》2023年第7期816-821,共6页Guangdong Medical Journal

基　　金：河北省医学科学研究重点课题计划(20181504);保定市科技计划项目(2041ZF031)。

摘　　要：目的探讨光动力疗法(PDT)联合白蛋白结合型紫杉醇化疗治疗肺癌致中心气道狭窄的临床效果及安全性。方法选取2019年1月至2021年1月收治的60例肺癌致中心气道狭窄患者,使用随机数字表法分成观察组与对照组各30例。对照组实施PDT治疗,观察组在此基础上联合白蛋白结合型紫杉醇化疗,连续治疗2个周期后观察两组近期疗效和毒性不良反应。比较治疗前后两组气道狭窄、气促分级、肺功能及生活质量。统计两组远期生存情况。结果治疗后,观察组近期疗效、气促分级均显著优于对照组(P<0.05)。观察组治疗前后气道狭窄段最小直径、气道狭窄程度、第1秒用力呼气容积与用力肺活量比值(FEV_(1)/FVC)、呼气峰值流量(PEF)和用力呼出75%肺活量时的瞬间呼气流量(FEF_(75%))及EORTC QLQ-LC13中气促、咳嗽、咯血、胸痛、吞咽困难及其他部位疼痛评分差值均显著优于对照组(P<0.05)。观察组化疗相关毒性不良反应以1~2级为主。观察组中位无进展生存时间(mPFS)、中位总生存期(mOS)分别为5.6、13.1个月,较对照组(4.3、10.2个月)均显著延长(P<0.05)。结论PDT联合白蛋白结合型紫杉醇化疗对肺癌致中心气道狭窄患者具有确切的临床疗效。Objective To investigate the clinical efficacy and safety of albumin bound paclitaxel chemotherapy combined with photodynamic therapy(PDT)in the treatment of central airway stenosis caused by lung cancer.Methods Sixty patients with central airway stenosis caused by lung cancer from January 2019 to January 2021 were randomly divided into observation group and control group.Patients in the control group were treated with PDT,and those in the observation group were treated with PDT combined with albumin bound paclitaxel chemotherapy.After 2 consecutive cycles of treatment,the short-term efficacy and toxic and side effects of the two groups were observed.The airway stenosis,dyspnea grades,pulmonary function and quality of life were compared between the two groups before and after treatment.The long-term survival of the two groups was analyzed.Results The recent efficacy and dyspnea grades of the observation group were significantly better than those of the control group after treatment(P<0.05).The observation group showed significant improvements in the minimum diameter of the narrowed airway segment,degree of airway stenosis,FEV_(1)/FVC,PEF,FEF75%,and scores for dyspnea,cough,hemoptysis,chest pain,dysphagia,and pain in other body parts in EORTC QLQ-LC13 before and after treatment compared to the control group(P<0.05).The observation group mainly experienced grade 1-2 chemotherapy-related toxic and adverse reactions.The median progression-free survival(mPFS)and median overall survival(mOS)of the observation group were 5.6 and 13.1 months,respectively,which were significantly longer than those of the control group(4.3 and 10.2 months,respectively)(P<0.05).Conclusion PDT combined with albumin bound paclitaxel chemotherapy has definite clinical effect on patients with central airway stenosis caused by lung cancer.

关 键 词：肺癌 中心气道狭窄 白蛋白结合型紫杉醇 光动力疗法 近期疗效 远期预后 毒性不良反应 

分 类 号：R734.2[医药卫生—肿瘤] R544.1[医药卫生—临床医学]