摘要
目的观察去甲长春花碱(NVB)、异环磷酰胺(IFO)和大剂量顺铂(DPP)分别经外周静脉滴注(IVD)、支气管动脉灌注(BAI)和支气管动脉与肺动脉双重灌注(DAI)化疗方法治疗中晚期非小细胞肺癌(NSCLC)的临床疗效及毒副反应.方法 72例NSCLC随机分为IVD组、BAI组和DAI组,各24例,化疗方案均用NIP(NVB 30 mg/m2;DPP 80 mg/m2,第1天;IFO 2.0 g,第1～3天),28 d为一个周期,至少治疗2个周期.结果三组的近期有效率分别为58.3%(14/24)、75.0%(18/24)和95.8%(23/24),差异有显著性(P<0.05).毒副作用主要为骨髓抑制,白细胞减少发生率达100.0%,其中Ⅲ度、Ⅳ度发生率为59.7%(43/72);IVD组75.0%(18/24),BAI组58.3%(14/24),DAI组45.8%(11/24).BAI组和DAI组(介入组)较IVD组低,差异有显著性(P<0.05).结论采用单纯BAI能使高浓度化疗药物作用于肿瘤局部,提高疗效,降低毒性反应;而采用DAI不仅提高疗效,降低毒性反应,还能弥补单纯BAI的某些不足,同时提高手术切除率.
Objective To evaluate the efficacy and toxicity of three chemotherapy regimens with NVB, IFO and large dose of DDP in the treatment of patients with middle stage-advanced NSCLC. Methods Seventy-two patients with NSCLC were randomly divided into three groups （ 1VD, BM, DM）. All of the patients received NIP regimen（NVB 30 mg/m^2 ,DDP 80 mg/m^2 on the first day,IFO 2.0 g on the first three days）by intravenous dripping （IVD） bronchial artery infusion（BM） and double artery bronchial artery and pulmonary artery infusion（DM） for at least 2 cycles, one cycle comprised 28 days. Results The short-term effective rates were 58.3 % （14/24）in group IVD,75.0% （ 18/24）in group BM and 95.8% （23/24）in group DM, with significant difference （ P 〈 0.05）. The main toxicity was myeLosuppression and the incidence rate of leucopenia was 100%. The incidence rates of toxicity in group BAI and group DAI were much lower than that in group IVD（P〈0.O5）.Conclusion BAI can distribute high concentration of the drugs to local tumor, thus raising curative effect and reducing toxicity. DAI can compensate some deficiencies of BM and raise excision rate.
出处
《中国肿瘤临床与康复》
2005年第4期328-331,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
