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目的观察肺癌患者行肺动脉与支气管动脉双重插管化疗(DA I)肿瘤缓解后行II期手术切除治疗的疗效。方法78例肺癌患者行肺动脉与支气管动脉双重插管化疗,18例行手术治疗,有16例行肺叶或全肺切除肿瘤和纵隔淋巴结。结果78例中DA I总有效率达91%,肺癌肿瘤区的肿瘤中心出现不同程度的坏死,坏死程度与肿瘤区血管染色呈正相关,16例中有8例肿瘤坏死程度达90%,坏死程度>50%有3例,另有5例坏死<50%。术后1、3、5年生存率为67%,50%,38%。其中有4例患者已存活10年。结论肺动脉参与肺癌组织的供血,行肺动脉与支气管动脉双重插管化疗后肿瘤发生以中心坏死为主的反应,可以使部分肿瘤得到根治切除,提高手术疗效及患者存活率。
Objective To observe the effect of stage II resection after remission of lung cancer and bronchial artery dual intubation chemotherapy (DAI) in patients with lung cancer. Methods A total of 78 patients with lung cancer underwent double intubation chemotherapy of pulmonary artery and bronchial artery. 18 patients underwent surgery. Sixteen patients underwent lobectomy or pneumonectomy and mediastinal lymph node dissection. Results The total effective rate of DA I in 78 cases was 91%. There were different degrees of necrosis in the tumor center of lung cancer. The degree of necrosis was positively correlated with the vascular staining in the tumor area. Eight of 16 patients had tumor necrosis of 90% > 50% in 3 cases, another 5 cases of necrosis <50%. The 1, 3, 5-year survival rates were 67%, 50% and 38% respectively. Four of these patients have survived for 10 years. Conclusions Pulmonary artery is involved in the supply of lung cancer tissue. The central necrosis of the tumor after double intubation of pulmonary artery and bronchial artery leads to radical resection of the tumor, which can improve the curative effect and survival rate.