摘要
目的 研究经支气管动脉碘油化疗栓塞术治疗支气管肺癌的临床应用价值。材料与方法 5 0例支气管肺癌 ,腺癌 17例 ,鳞癌 30例 ,小细胞肺癌 3例。其中 a期 4例 , b期 17例 , a期 2 2例 , b期 7例。支气管动脉造影明确该动脉的分支和肿瘤血管 ,选择性插管肿瘤血管 ,行局部灌注化疗后 ,以 3～ 10 ml碘油加 10 0 mg卡铂的乳剂进行栓塞。结果 (1)栓塞血管 :左支气管动脉干 5例 ,其肿瘤分支 13例 ,右支气管动脉干 4例 ,其肿瘤分支 2 1例 ,左右共干之左支气管动脉肿瘤支 3例 ,左右共干之右支气管动脉肿瘤支 4例。 (2 )近期疗效 :CR 1例 ,PR 37例 ,SD 12例 ,PD 0例 ,有效率 76 %。症状缓解率 44 .4%。 (3)并发症 :9例在支气管动脉干栓塞治疗者 ,1例出现一过性脊髓缺血 ;3例支气管动脉 -肋间动脉共干且在支气管动脉干栓塞治疗者 ,均出现肋间动脉并发症 ;在支气管动脉肿瘤支栓塞者未出现以上并发症。栓塞过程中出现肺动脉分支碘油沉积者占 12 % ,4%伴有症状。上述并发症对症治疗后均缓解。结论 支气管动脉碘油化疗栓塞术治疗支气管肺癌近期疗效较好 。
Objective To evaluate transbronchial arterial chemoembolization with carbodoxin Lipiodol mixture in the treatment of lung cancer. Materials and Methods In this study 50 patients with lung cancer were collected, of which adenocarcinoma was seen in 17, squamous cell carcinoma in 30 and small cell carcinoma in 3. The clinical staging was 4 cases in Ⅱa, 17 in Ⅱb, 22 in Ⅲa and 7 in Ⅲb. Bronchial arteriography was carried out to identify the tumor feeding branch for super selective catheterization with coaxial microcatheter technique. After 200mg carboplatin, 10～20mg mitomycin C and 500～1000mg 5 FU was infused, embolization with the mixture of 3～10ml Lipiodol and 100mg carboplatin was performed.Results (1) Embolized arteries included left bronchial artery (n=5) and its tumor branch (n=13), right bronchial artery (n=4) and its tumor branch (n=21), left branch (n=3) and right branch (n=4) in cases with common bronchial artery. (2) Short term effectiveness: complete response (CR) was achieved in one cases, while partial response (PR) in 37, steady disease (SD) in 12, and no deterioration was seen. The total effectiveness (CR plus PR) was up to 76%. Clinical symptoms were relieved in 44.4%. (3) Complications: Transient myelitis developed in 1 of 9 cases in whom embolization of bronchial artery trunk was done. Intercostal artery ischemic symptoms occurred in all 3 patients who had a common trunk of bronchial intercostal arteries and who had the bronchial artery embolized. None of the above complications developed in the patients in whom the tumor feeding branch from the bronchial artery was embolized. During the procedure, Lipiodol deposit in pulmonary arterial branches was seen in 12% of cases, and slight respiratory distress developed in 4%, which was relieved after symptomatic management.Conclusion Transbronchial arterial chemoembolization with carbodoxin Lipiodol mixture has good short term effect in the treatment of lung cancer. Super selective tumor feeding artery catheterization may avoi
出处
《临床放射学杂志》
CSCD
北大核心
2001年第10期796-798,共3页
Journal of Clinical Radiology
基金
"九五"国家医学科技攻关基金项目 (96- 90 7- 0 3- 0 3)
