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投稿时间：2022-11-29 网络发布日期：2023-06-20
投稿时间：2022-11-29 网络发布日期：2023-06-20
中文摘要: 目的 探讨在晚期原发性肺癌合并大咯血治疗中CalliSpheres?载药栓塞微球经支气管动脉化疗栓塞（DEB-BACE）应用的疗效及安全性。 方法 回顾性分析2019年12月至2021年12月临沂市肿瘤医院收治的45例晚期原发性肺癌合并大咯血患者的临床资料。所有患者均接受支气管动脉栓塞治疗,依据栓塞材料不同分为观察组（n=24）和对照组（n=21）。观察组患者采用CalliSpheres?载药微球加载表柔比星40～60 mg行DEB-BACE治疗,对照组患者采用8Spheres?空白微球行支气管动脉栓塞术（BAE）治疗。观察两组患者咯血控制、肿瘤反应、患者生存期及治疗相关不良反应。 结果 止血成功率观察组87.5%,对照组85.7%,差异无统计学意义（P＞0.05）;观察组中位无咯血持续时间为96 d,高于对照组的50 d，差异有统计学意义（P＜0.01）。栓塞治疗后2个月,观察组患者的客观缓解率（ORR）为83.3%,高于对照组的38.1%,差异有统计学意义（P＜0.05）。两组与栓塞治疗相关的不良反应主要为发热、胸闷和胸痛,对症治疗后好转,未见与栓塞相关的脊髓损伤、脑栓塞等严重并发症,两组的不良反应差异无统计学意义（P＞0.05）。截至2022年9月30日,随访时间2~25（9.97±5.41）个月,观察组中位OS为10个月,对照组为6个月,差异有统计学意义（P＜0.01）。 结论 与传统的BAE相比,DEB-BACE治疗晚期肺癌合并大咯血可以获得更高的肿瘤反应率,更长的无咯血生存期和总生存期。
中文关键词: 肺癌, 原发性 大咯血 支气管动脉化疗栓塞术 载药微球 支气管动脉栓塞术
Abstract:Objective To explore the efficacy and safety of CalliSpheres? drug-eluting beads trans-bronchial artery chemoembolization (DEB-BACE) . Methods A retrospective analysis was conducted on 45 patients with advanced primary lung cancer complicated with massive hemoptysis treated in Linyi Cancer Hospital from December 2019 to December 2021. All patients received bronchial artery embolization (BAE) and were divided into observation group (n=24) and control group (n=21) according to different embolization materials. DEB-BACE using CalliSpheres? drug-eluting beads loading 40-60 mg of epirubicin was performed in observation group, and BACE with 8Spheres? blank microspheres was given in control group. The control of hemoptysis, tumor response, the survival time and the related adverse reactions were observed and compared between two groups. Results There was no significant difference in hemostatic success rate between observation group and control group (87.5% vs 85.7%, P＞0.05) . The median duration of nonmassive hemoptysis in observation group was statistically longer than that in control group (96 days vs 50 days, P＜0.01) . At two months after embolization therapy, the objective response rate (83.3% vs 38.1%) in observation group were significantly higher than those in control group (P＜0.05) . The fever, chest tightness and chest pain related to the embolization treatment disappeared after symptomatic treatment in two groups, and there was no statistical difference in adverse reactions between two groups (P＞0.05) . No serious complications such as spinal cord injury and cerebral embolism occurred in two groups. By the end of September 30, 2022, the median overall survival in observation group (10 months) was statistically higher than that in control group (6 months) (P＜0.01) at a follow-up of 2-25 (9.97±5.41) month. Conclusion In the treatment of advanced lung cancer with massive hemoptysis, DEB-BACE can achieve higher tumor response rate, longer survival time without hemoptysis and total survival time compared with conventional BAE.
keywords: Lung cancer, primary Massive hemoptysis Bronchial arterial chemoembolization Drug-eluting beads Bronchial artery embolization
文章编号： 中图分类号：R734 文献标志码：A
基金项目:临沂市科技发展计划项目 (202120026)
附件
| Author Name | Affiliation |
| LIU Song, BAI Xiangyun, WANG Qingdong, YU Guangji, LI Ling, ZHU Zhizhen | Department of Intervention, Linyi Cancer Hospital, Linyi, Shandong 276034, China |
引用文本：
刘松, 柏祥云, 王庆东, 于广计, 李玲, 朱志真.CalliSpheres®载药微球经支气管动脉化疗栓塞治疗晚期原发性肺癌合并大咯血的疗效和安全性[J].中国临床研究,2023,36(6):844-848.
刘松, 柏祥云, 王庆东, 于广计, 李玲, 朱志真.CalliSpheres®载药微球经支气管动脉化疗栓塞治疗晚期原发性肺癌合并大咯血的疗效和安全性[J].中国临床研究,2023,36(6):844-848.