论文部分内容阅读
目的 评价支气管动脉灌注化疗作为术前化疗方法对Ⅲ期非小细胞肺癌的治疗效果。方法 选择临床Ⅲ期肺癌 30例 (ⅢA 2 7例 ,ⅢB 3例 ) ,予以选择性支气管动脉灌注化疗。方案为 :( 1)顺铂 ( 4 0mg/m2 )、丝裂霉素 ( 10mg/m2 )及阿霉素 ( 4 0mg/m2 )于第 1、2 9d经患侧支气管动脉注入 ;( 2 )顺铂 ( 4 0mg/m2 )第 2、30d经iv注入。记录与治疗有关的副反应 ;治疗结束后再行分期检查 ,评价疗效 ;对有手术指征者行外科治疗 ,记录手术及术后情况 ,并对切除标本进行病理学检查。结果 支气管动脉灌注化疗后临床有效率为 83.3% (CR 6例 ,PR 19例 ) ,SD 4例 ,进展 1例。外科治疗 2 9例 ,根治切除 2 5例 ,切除率为 86 .2 %。围手术期发生严重并发症 2例 ,其中 1例死亡。病理检查 :仅发现 1例为病理CR。结论 术前支气管动脉灌注化疗可有效地降低Ⅲ期NSCLC的分期 ,提高手术切除率 ,但治愈Ⅲ期NSCLC的可能性很小。该综合治疗方法的远期效果有待进一步观察。
Objective To evaluate the effect of bronchial artery infusion chemotherapy as a preoperative chemotherapy on stage Ⅲ non-small cell lung cancer. Methods Thirty patients with stage Ⅲ lung cancer (ⅢA 7, ⅢB 3) were selected and treated with selective bronchial artery infusion chemotherapy. The protocol was: (1) Cisplatin (40mg / m2), mitomycin (10mg / m2) and doxorubicin (40mg / m2) Cisplatin (40mg / m2) 2d, 30d iv injection. Record and treatment-related side effects; after treatment, staging and assessing the curative effect; Surgical treatment of surgical indications, surgery and postoperative records, and the removal of specimens for pathological examination. Results The clinical effective rate after bronchial artery infusion chemotherapy was 83.3% (CR 6 cases, PR 19 cases), SD 4 cases, 1 case progressed. Surgical treatment of 29 cases, 25 cases of radical resection, resection rate of 86.2%. Perioperative complications occurred in 2 cases, of which 1 died. Pathological examination: only one case was found to be pathologic CR. Conclusion Preoperative bronchial artery infusion chemotherapy can effectively reduce the stage of stage Ⅲ NSCLC and improve the resection rate, but the possibility of curing stage Ⅲ NSCLC is very small. The long-term effect of this comprehensive treatment needs further observation.