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目的:通过前瞻性对照研究,比较肺动脉灌注化疗与外周静脉化疗对中晚期肺癌行肺叶切除术后的治疗效果。方法:病人分为2组(每组45例),PAI 组于肺叶切除后行选择性肺动脉置管于手术侧剩余肺叶间动脉内,灌注化疗。Ⅵ组则于术后用外周静脉给药途径化疗。结果:PAI组共化疗215疗程,平均4.7疗程,Ⅵ组化疗195疗程,平均4.3疗程。PAI组根治手术病例1、3、5年生存率94％、84.6％、52.9％,Ⅵ组1、3、5年生存率为87.5％、60％、22.2％,其中3、5年生存率有显著性差异 P<0.05。Ⅵ组行姑息手术病例 1年生存率 45％,无 3年生存率。PAI 组姑息手术病例 1、3年生存率为50％、33.3％优于Ⅵ组,但无统计学差异。PAI组根治手术病例3年局部复发率为12.8％,Ⅵ组为35％,有显著性差异,P<0.05。PAI组 1、3、5年血行转移复发率为 17.8％、20％、26.3％,Ⅵ组为15.5％、35％、51.3％,其中3、5年血行转移率减少有显著性差异P<0.05。结论:选择性肺动脉灌注化疗作为一种新的化疗方式,用于肺叶切除术后的肺癌患者,具有提高局部化疗药物浓度、增强化疗效果的作用,能够杀灭和抑制局部微转移灶,减少局部复发和远期血行转移的发生率,改善长期生存率。
OBJECTIVE: To compare the therapeutic effects of pulmonary artery perfusion chemotherapy and peripheral intravenous chemotherapy on lobectomy in patients with advanced lung cancer through a prospective controlled study. METHODS: The patients were divided into 2 groups (45 in each group). The PAI group underwent selective pulmonary artery catheter placement in the remaining interlobar artery after lobectomy and perfusion chemotherapy. Group VI was treated with peripheral intravenous administration after chemotherapy. RESULTS: In the PAI group, 215 courses of chemotherapy were performed, with an average of 4.7 courses of treatment. In the VI group, 195 courses of chemotherapy were performed, with an average of 4.3 courses of treatment. In the PAI group, the 1-, 3-, and 5-year survival rates for radical surgery were 94%, 84.6%, and 52.9%. The VI, 1-, 3-, and 5-year survival rates were 87.5%, 60%, and 22.2%. The 3 and 5-year survival rates were Significant difference P<0.05. The 1-year survival rate of palliative surgery in group VI was 45%, and there was no 3-year survival rate. In the PAI group, the 1-year, 3-year survival rate was 50% and 33.3% was better than the VI group, but there was no statistical difference. The local recurrence rate in radical resection of PAI group was 12.8% at 3 years and 35% in VI group, with significant difference (P<0.05). The recurrence rate of hematogenous metastasis in PAI group was 17.8%, 20%, and 26.3% in group 1, 15.5%, 35%, and 51.3% in group VI. There was a significant difference in hematogenous metastasis rate between 3 and 5 years P<0.05. . Conclusion: Selective pulmonary arterial infusion chemotherapy as a new chemotherapy for lung cancer patients after lobectomy has the effect of increasing the concentration of local chemotherapy drugs and enhancing the effect of chemotherapy. It can kill and suppress local micrometastasis and reduce local The incidence of recurrence and long-term hematologic metastases improves long-term survival.