[1]李虎子,赵 成,方文岩,等.多靶动脉减量灌注化疗联合125I放射性粒子植入治疗ⅢB期非小细胞肺癌的临床意义[J].介入放射学杂志,2021,30(09):893-898.
 LI Huzi,ZHAO Cheng,FANG Wenyan,et al.Clinical significance of multi-targeted arterial reduced-dose infusion chemotherapy combined with 125I radioactive seeds implantation for the treatment of stage ⅢB non-small cell lung cancer[J].journal interventional radiology,2021,30(09):893-898.
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多靶动脉减量灌注化疗联合125I放射性粒子植入治疗ⅢB期非小细胞肺癌的临床意义()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
30
期数:
2021年09
页码:
893-898
栏目:
肿瘤介入
出版日期:
2021-09-25

文章信息/Info

Title:
Clinical significance of multi-targeted arterial reduced-dose infusion chemotherapy combined with 125I radioactive seeds implantation for the treatment of stage ⅢB non-small cell lung cancer
作者:
李虎子 赵 成 方文岩 张 洪 贺 斌 段振东
Author(s):
LI Huzi ZHAO Cheng FANG Wenyan ZHANG Hong HE Bin DUAN Zhendong.
Department of Oncology, First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300192, China
关键词:
【关键词】 支气管动脉灌注化疗 放射性粒子植入 静脉化疗 非小细胞肺癌 进展期
文献标志码:
A
摘要:
【摘要】 目的 比较研究125I放射性粒子植入联合多靶动脉减量灌注化疗治疗ⅢB期非小细胞肺癌(NSCLC)与联合静脉化疗临床疗效的差异。 方法 选取在2013年7月至2018年12月接受局部125I放射性植入治疗联合化疗的ⅢB期NSCLC患者作为研究对象,收集患者各项临床特征资料,包括性别、年龄、体力状况、吸烟指数、病理类型、化疗方式、肿瘤体积(gross tumor volume,GTV)和100%靶区所受剂量(D100)等,接受动脉灌注化疗的患者为MAC组,接受静脉化疗的患者为SVC组。随访并行短期疗效评价和记录生存时间。 结果 57例SVC组CR、PR、SD和PR患者分别为1.8%(1/57)、47.4%(27/57)、45.6%(26/57)和5.3%(3/57),OR为49.1%; 19例MAC组患者CR、PR、SD和PR分别为15.8%(3/19)、52.6% (10/19)、21.1%(4/19)和10.5%(2/19),OR为68.4%;两组差异有统计学意义(χ2=8.192,P=0.042)。SVC组患者1、2和3年生存率分别为73.7%、26.3%和8.8%,mOS为16.3个月;MAC组患者1、2和3年生存率为84.2%、42.1%和15.8%,mOS为20.0个月;两组差异有统计学意义(χ2=3.916,P=0.048)。亚组分析显示单一支气管动脉供血的患者mOS为25.0个月,多靶动脉供血患者mOS为16.8个月,两组患者OS差异明显(χ2=3.944,P=0.047)。应用Cox模型单因素分析显示:GTV(HR=3.090,95%CI:1.057-8.884,P=0.036)、D100(HR=4.463,95%CI:1.261-15.798,P=0.020)、供血动脉(HR=5.885,95%CI:1.877-18.449,P=0.002)与OS显著相关,多因素分析显示:多靶动脉供血是影响OS的独立危险因素(HR=4.776,95%CI:1.265-18.039,P=0.021)。结论 125I放射性粒子植入治疗联合多靶动脉减量灌注化疗治疗ⅢB期NSCLC在局部病灶控制、延长生存时间方面优于联合静脉化疗,可作为治疗手段之一进行临床推广。

参考文献/References:

[1] Qiu H, Ji J, Shao Z, et al. The efficacy and safety of iodine- 125 brachytherapy combined with chemotherapy in treatment of advanced lung cancer: a meta- analysis[J]. J Coll Physicians Surg Pak, 2017, 27: 237- 245.
[2] De Ruysscher D, van Baardwijk A, Wanders R, et al. Indivi- dualized accelerated isotoxic concurrent chemo- radiotherapy for stage Ⅲ non- small cell lung cancer: 5- year results of a prospective study[J]. Radiother Oncol, 2019, 135: 141- 146.
[3] Postmus PE, Kerr KM, Oudkerk M, et al. Early and locally advanced non- small- cell lung cancer(NSCLC): ESMO clinical practice guidelines for diagnosis, treatment and follow- up[J]. Ann Oncol, 2017, 28(Suppl 4): iv1- iv21.
[4] 湛永滋,黄昌杰,黄剑锋,等. Ⅲ期非小细胞肺癌同步放化疗的临床研究[J]. 中国癌症杂志, 2007, 17: 524- 526.
[5] Curran WJ Jr, Paulus R, Langer CJ, et al. Sequential vs. concurrent chemoradiation for stage Ⅲ non- small cell lung cancer: randomized phase Ⅲ trial RTOG 9410[J]. J Natl Cancer Inst, 2011, 103: 1452- 1460.
[6] Zatloukal P, Petruzelka L, Zemanova M, et al. Concurrent versus sequential chemoradiotherapy with cisplatin and vinorelbine in locally advanced non- small cell lung cancer: a randomized study[J]. Lung Cancer, 2004, 46: 87- 98.
[7] Watanabe Y, Shimizu J, Murakami S, et al. Reappraisal of bronchial arterial infusion therapy for advanced lung cancer[J]. Jpn J Surg, 1990, 20: 27- 35.
[8] Osaki T, Hanagiri T, Nakanishi R, et al. Bronchial arterial infusion is an effective therapeutic modality for centrally located early- stage lung cancer: results of a pilot study[J]. Chest, 1999, 115: 1424- 1428.
[9] 李晓东,刘庆祥. 吉西他滨联合顺铂动、静脉介入化疗对肺癌移植瘤大鼠肿瘤生长抑制作用的比较[J]. 现代肿瘤医学, 2020, 28:387- 391.
[10] Viamonte M Jr. Selective bronchial arteriography in man: preliminary report[J]. Radiology, 1964, 83: 830- 839.
[11] Nakanishi M, Yoshida Y, Natazuka T. Prospective study of transarterial infusion of docetaxel and cisplatin to treat non- small- cell lung cancer in patients contraindicated for standard chemotherapy[J]. Lung Cancer, 2012, 77: 353- 358.
[12] Nakanishi M, Umeda Y, Demura Y, et al. Effective use of multi- arterial infusion chemotherapy for advanced non- small cell lung cancer patients: four clinical specified cases[J]. Lung Cancer, 2007, 55: 241- 247.
[13] Nakanishi M, Demura Y, Umeda Y, et al. Multi- arterial infusion chemotherapy for non- small cell lung carcinoma: significance of detecting feeding arteries and tumor staining[J]. Lung Cancer, 2008, 61: 227- 234.
[14] 荣振华,刘鹏捷,刘光丽,等. 中晚期中央型肺癌应用支气管动脉介入治疗的临床研究[J]. 中外医疗, 2019, 38:92- 94.
[15] 肖湘生,董 生,董伟华,等. 肺癌血供系列研究[J]. 介入放射学杂志, 2008, 17:169- 171.
[16] 王晓燕,肖继伟.支气管动脉CTA检查在中央型肺癌患者介入术前的指导价值[J]. 影像科学与光化学, 2020, 38:318- 322.
[17] Fu YF, Li Y, Wei N, et al. Transcatheter arterial chemical infusion for advanced non- small- cell lung cancer: long- term outcome and predictor of survival[J]. Radiol Med, 2016, 121: 605- 610.
[18] Fan J, Du J, Wu J, et al. Antitumor effects of different administration sequences of cisplatin and Endostar on Lewis lung carcinoma[J]. Oncol Lett, 2015, 9: 822- 828.
[19] Ye XD, Yuan Z, Ye JD, et al. Assessment of the feeding arteries by three- dimensional computed tomography angiography prior to multi- arterial infusion chemotherapy for lung cancer[J]. Oncol Lett, 2013, 5: 363- 367.
[20] Yu H, Liu SY, Li HM, et al. Empirical description of bronchial and nonbronchial arteries with MDCT[J]. Eur J Radiol, 2010, 75: 147- 153.
[21] 蒲德利,廖江荣. 放射性125I粒子植入联合支气管动脉灌注化疗治疗晚期肺癌疗效观察[J]. 中国现代医药杂志, 2017, 19:7- 10.
[22] 孙振友,相法军,韩德娟,等. 支气管动脉灌注化疗联合放疗治疗中晚期非小细胞肺癌的Meta分析[J]. 世界最新医学信息文摘, 2019, 19:120.
[23] Zhang B, Tao F, Zhang H. Metastasis- associated protein 2 promotes the metastasis of non- small cell lung carcinoma by regulating the ERK/AKT and VEGF signaling pathways[J]. Mol Med Rep, 2018, 17: 4899- 4908.
[24] Denton E, Conron M. Improving outcomes in lung cancer: the value of the multidisciplinary health care team[J]. J Multidiscip Healthc, 2016, 9: 137- 144.
[25] 唐 涛,丁长青,孙祖杰,等. 三维适型放疗联合支气管动脉灌注栓塞治疗Ⅲ期非小细胞肺癌64例的疗效分析[J]. 中国社区医师, 2017, 33:34- 37.
[26] 胡爱平,陈宗祥,梁洪亮. 小剂量支气管动脉灌注化疗联合局部放射治疗高龄非小细胞肺癌的临床观察[J]. 中华肺部疾病杂志(电子版), 2013, 6:42- 45.
[27] Wang ZM, Lu J, Liu T, et al. CT- guided interstitial brachytherapy of inoperable non- small cell lung cancer[J]. Lung Cancer, 2011, 74: 253- 257.
[28] 王 斌,汪 建,张西坤,等. 放射性125I粒子植入联合全身化疗治疗Ⅲ期中央型肺鳞状细胞癌短期效果评价[J]. 山东医药, 2020, 60:54- 56.
[29] Yang SF, Fan XW, Zhang GQ, et al. Efficacy and safety of chemotherapy combined with interstitial125I seed implantation brachytherapy in unresectable stage IIIa/IIIb non- small cell lung cancer[J]. Zhonghua Zhong Liu Za Zhi, 2010, 32: 626- 629.
[30] Huo XD, Huo B, Wang HX, et al. Implantation of computed tomography- guided iodine- 125 seeds in combination with chemotherapy for the treatment of stage Ⅲ non- small cell lung cancer[J]. J Contemp Brachytherapy, 2017, 9: 527- 534.

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备注/Memo

备注/Memo:
(收稿日期:2020- 06- 16)
(本文编辑:俞瑞纲)
更新日期/Last Update: 2021-09-13