载药微球支气管动脉化疗栓塞对高龄中晚期肺癌患者的疗效及安全性  

DEB-BACE for the treatment of advanced lung cancer in the elderly patients:its clinical efficacy and safety

作　　者：徐芬芬 赖林强 叶泽康 张登科[2] 陈洁[2] 涂建飞[2] XU Fenfen;LAI Linqiang;YE Zekang;ZHANG Dengke;CHEN Jie;TU Jianfei(Fifth Affiliated Hospital of Wenzhou Medical University,Lishui,Zhejiang Province 323000,China)

机构地区：[1]温州医科大学附属第五医院丽水市中心医院康复科,浙江丽水323000 [2]温州医科大学附属第五医院丽水市中心医院肿瘤中心,浙江丽水323000 [3]温州医科大学附属第五医院丽水市中心医院神经内科,浙江丽水323000

出　　处：《介入放射学杂志》2024年第12期1313-1319,共7页Journal of Interventional Radiology

基　　金：国家卫生健康委员会,浙江省医药卫生重大科技计划重点项目(WKJ-ZJ-1932);浙江省医学会临床医学专项基金(2022ZYC-A263);湖北陈孝平科技发展基金(CXPJJH122022-015)。

摘　　要：目的探讨载药微球支气管动脉化疗栓塞(DEB-BACE)和单纯静脉化疗对高龄中晚期肺癌患者的疗效及安全性。方法纳入丽水市中心医院2018年1月至2022年1月收治的年龄>65岁的中晚期肺癌患者213例,根据患者接受的治疗方式,分为化疗组和DEB-BACE组。匹配前化疗组107例,DEB-BACE组106例,经过倾向性评分匹配后化疗组和DEB-BACE组各42例。比较两组患者的短期疗效、不良反应发生率。利用生存曲线和Log-rank检验比较两组患者的生存情况。采用Cox回归分析预后生存的影响因素。结果治疗后1、3、6个月DEB-BACE组的疾病控制率和客观缓解率均优于化疗组。匹配前DEB-BACE组中位无进展生存时间(mPFS)为7.0个月,化疗组为6.0个月(P<0.001)。匹配后DEB-BACE组mPFS为7.0个月,化疗组为5.0个月(P=0.001)。匹配前DEB-BACE组中位生存时间(mOS)为23.0个月,化疗组为20.0个月(P<0.001)。匹配后DEB-BACE组mOS为24.0个月,化疗组为18.0个月(P=0.001)。多因素Cox回归分析发现,治疗方式、肿瘤大小、TNM分期是总生存时间的影响因素。匹配前后DEB-BACE组治疗后骨髓抑制发生率均低于化疗组(P<0.05)。结论应用DEB-BACE治疗高龄中晚期肺癌,比全身静脉化疗的疗效和安全性更佳。Objective To compare the curative effect and safety of drug-eluting beads bronchial artery chemoembolization(DEB-BACE)with those of simple intravenous chemotherapy in treating elderly patients with intermediate to advanced lung cancer.Methods A total of 213 patients aged>65 years with intermediate to advanced lung cancer,who were admitted to the Lishui Municipal Central Hospital of China between January 2018 and January 2022,were enrolled in this study.According to the therapeutic scheme,the patients were divided into chemotherapy group(n=107)and DEB-BACE group(n=106).After propensity score matching,chemotherapy group and the DEB-BACE group had 42 patients each.The short-term efficacy and the incidence of adverse reactions were compared between the two groups.Survival curve and Log-rank test were used to compare the survival between the two groups.Cox regression analysis was used to analyze the factors influencing the prognostic survival.Results The postoperative one-,3-,and 6-month disease control rate and objective remission rate in DEB-BACE group were better than those in the chemotherapy group.Before propensity score matching,the median progression-free survival(mPFS)time in DEB-BACE group was 7.0 months,which in the chemotherapy group was 6.0 months(P<0.001).After propensity score matching,the mPFS in DEB-BACE group was 7.0 months,which in the chemotherapy group was 5.0 months(P=0.001).Before propensity score matching,the median overall survival(mOS)time in DEB-BACE group was 23.0 months,which in the chemotherapy group was 20.0 months(P<0.001).After propensity score matching,the mOS in DEB-BACE group was 24.0 months,which in the chemotherapy group was 18.0 months(P=0.001).Multivariate Cox regression analysis revealed that therapeutic scheme,tumor size,and TNM stage were the influencing factors for OS.In terms of the adverse reactions,the incidences of both the pre-matched and post-matched myelosuppression in DEB-BACE group were lower than those in the chemotherapy group(P<0.05).Conclusion For the treatment o

关 键 词：中晚期肺癌 高龄人群 支气管动脉化疗栓塞 载药微球 

分 类 号：R734.2[医药卫生—肿瘤]