摘要
目的:支气管动脉化疗栓塞术是临床常用的血管介入治疗技术,在中晚期肺癌中治疗比较多见;Callispheres是近年来新兴的肿瘤动脉栓塞的药物加载微球,已在多种肿瘤治疗中获益。本研究的目的是评估Callispheres载药微球栓塞对比传统的化疗灌注栓塞治疗的不可切除的Ⅱ期以上中央型鳞癌患者的临床获益和并发症。方法:回顾性分析本院2017年1月—2020年12月收治的患者病例资料,按治疗手段分组进行队列研究。根据传统的支气管动脉灌注栓塞(C-BACE)以及Callispheres加载吉西他滨进行支气管动脉化学栓塞(D-BACE)对患者进行分组。比较两组的肿瘤实体瘤变化、无进展生存期、总生存期,血清肿瘤学检查变化和随访期间的并发症。结果:共有42例患者入组进行研究,每组21例,其中男34例,女8例;年龄48~81岁,中位年龄68岁。术后1月D-BACE组对比C-BACE组的疾病控制率(DCR)为85.7%、76.2%(P>0.05),客观缓解率(ORR)66.7%、66.7%(P>0.05);术后6月D-BACE组对比C-BACE组的DCR为85.7%、52.4%(P<0.05),ORR为76.2%、47.6%(P<0.05),具有统计学差异。术后总计随访两年中位无进展生存时间(PFS)12月和8月(t=4.123,P<0.05),总体生存期19.9月和14.7月(t=3.314,P<0.05);治疗后两组肿瘤标记物短期内变化无明显差异。两组之间的不良反应胸痛、乏力、发热、感觉异常及严重不良反应截瘫没有差异。结论:Callispheres加载吉西他滨行支气管动脉化疗栓塞治疗晚期肺鳞癌的短期(6月)疾病控制效果尚可,并且患者的PFS和总生存期上可获益,并且不会增加术后不良反应的发生率。
Objective: Bronchial artery chemoembolization is a commonly used vascular interventional therapy technique,which is more common in the treatment of advanced lung cancer. Callispheres is a new drug loaded microspheres for tumor arterial embolization in recent years, which has benefited from a variety of tumor treatments. The aim of this study was to evaluate the clinical benefits and complications of callispheres drug loaded microspheres embolization compared with traditional chemoperfusion embolization in patients with unresectable stage Ⅱ and above central squamous cell carcinoma. Methods: The case data of patients treated in our hospital from January 2017 to December 2020 were retrospectively analyzed, and the cohort study was carried out according to the treatment methods. Patients were grouped according to traditional bronchial artery perfusion embolization(C-BACE) and callispheres loaded gemcitabine for bronchial artery chemical embolization(D-BACE). The changes of solid tumor, progression free survival, overall survival, changes of serum oncology and complications during followup were compared between the two groups. Results: A total of 42 patients were enrolled in the study, 21 in each group, including 34 males and 8 females. The age ranged from 48 to 81 years old, with a median age of 68 years old. One month after operation, the disease control rate(DCR) of D-BACE group compared with C-BACE was 85.7%, 76.2%(P>0.05), and the objective remission rate(ORR) was 66.7%, 66.7%(P>0.05). Compared with C-BACE group, the DCR of D-BACE group was85.7%, 52.4%(P <0.05), and the ORR was 76.2%, 47.6%(P <0.05) six month after operation. There was statistical difference.The median progression free survival(PFS) was 12 months and 8 months(t=4.123, P<0.05), and the overall survival was 19.9months and 14.7 months(t=3.314, P<0.05). There was no significant difference in the short-term changes of tumor markers between the two groups after treatment. There was no difference in adverse reactions such as chest pain, fatigue, fever, paresthesia and paraplegia between the two groups. Conclusion: The short-term(6-month) disease control effect of bronchial artery chemoembolization with callispheres loaded gemcitabine in the treatment of advanced pulmonary squamous cell carcinoma is acceptable, and the patients can benefit from PFS and overall survival, and will not increase the incidence of postoperative adverse reactions.
作者
赵罡
史晓宝
卢再鸣
ZHAO Gang;SHI Xiao-bao;LU Zai-ming(Interventional Department,Shengjing Hospital of China Medical University,Shenyang 110004,China;The Fourth Hospital of China Medical University,Shenyang 110033,China)
出处
《中国临床医学影像杂志》
CAS
CSCD
2022年第6期435-440,共6页
Journal of China Clinic Medical Imaging
基金
北京医学奖励基金会(基金号HRIRF-2018-C020)。
关键词
肺肿瘤
癌
鳞状细胞
栓塞
治疗性
放射学
介入性
Lung Neoplasms
Carcinoma,Squamous Cell
Embolization,Therapeutic
Radiology,Interventional
