[肺癌合并上腔静脉综合征患者的介入治疗]

[Interventional therapy for lung cancer patients with superior vena cava syndrome].

作者信息

Luo Jie, Chen Bin, Jiang Sen, Zhou Song-wen

机构信息

Department of Oncology, Department of Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2013 Aug;35(8):627-31.

PMID:24314224

Abstract

OBJECTIVE

To investigate the method, therapeutic effect and safety of interventional therapy for lung cancer patients with superior vena cava syndrome (SVCS).

METHODS

Fifty-two cases of lung cancer with SVCS who received interventional therapy in our hospital between Jan to Dec 2011 were included in this study. Of the 52 cases, 50 cases had successfully carried out superior vena cava stent implantation. The distal venous pressure was measured before and after angioplasty, and the results were assessed by Wilcoxon matched-pairs test. In addition, the 50 patients were followed up and the therapeutic effect and postoperative survival rate were evaluated.

RESULTS

The mean distal venous pressure in the 50 patients was significantly decreased from preoperative (28.2 ± 1.9)cm H2O to postoperative (8.7 ± 0.5)cm H2O (P = 0.0085). The efficacy of the treatment was as follows: complete remission (20/52, 38.5%), partial remission (28/52, 53.8%), ineffective 4 (4/52, 7.7%), and total effective rate 92.3%. The complications after angioplasty and stent implantation included chest pain (12 cases, 23.1%), hematoma at the puncture site (5 cases, 9.6%), and fever (2 cases, 3.8%). No serious complications such as massive hemorrhage, pulmonary embolism and stent migration into the cardiac atrium were observed. The rate of postoperative restenosis was low (2/52, 3.8%). For the SCLC group, the objective effective rate was 74.1% and 1-year survival rate was 21.0%. For the NSCLC group, the objective effective rate was 21.7% and 1-year survival rate was 35.0%.

CONCLUSIONS

For lung cancer patients with SVCS, interventional therapy may relief obstruction effectively, promote blood flow recovery, and relieve clinical symptoms. Interventional therapy with endovascular angioplasty and stenting may be highly recommended as the first choice for palliative treatment of SVCS. It is an effective initial palliative treatment. However, subsequent comprehensive anti-tumor treatment is necessary.

摘要

目的

探讨肺癌合并上腔静脉综合征（SVCS）患者介入治疗的方法、疗效及安全性。

方法

选取2011年1月至12月在我院接受介入治疗的52例肺癌合并SVCS患者。52例患者中，50例成功进行了上腔静脉支架植入术。血管成形术前、后测量远端静脉压，结果采用Wilcoxon配对检验进行评估。此外，对50例患者进行随访，评估治疗效果及术后生存率。

结果

50例患者的平均远端静脉压术前为（28.2±1.9）cmH₂O，术后显著降至（8.7±0.5）cmH₂O（P = 0.0085）。治疗效果如下：完全缓解（20/52，38.5%），部分缓解（28/52，53.8%），无效4例（4/52，7.7%），总有效率92.3%。血管成形术和支架植入术后的并发症包括胸痛（12例，23.1%）、穿刺部位血肿（5例，9.6%）和发热（2例，3.8%）。未观察到严重并发症，如大出血、肺栓塞和支架移入心房。术后再狭窄率较低（2/52，3.8%）。小细胞肺癌（SCLC）组客观有效率为74.1%，1年生存率为21.0%。非小细胞肺癌（NSCLC）组客观有效率为21.7%，1年生存率为35.0%。