Li Fangjuan, Sun Xiwen, Liang Shixiong, Jiang Sen, Mao Ling
Department of Radiation Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.
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Zhonghua Zhong Liu Za Zhi. 2015 Jan;37(1):47-51.
To evaluate the effectiveness and safety of endovascular stent insertion for non-small cell lung cancer patients with superior vena cava syndrome.
We retrospectively studied 123 patients referred to our hospital for the treatment of non-small cell lung cancer presenting with superior vena cava syndrome. Patients were devided in two groups according to the use of endovascular stent insertion in superior vena cava syndrome or not. 64 patients underwent endovascular stent insertion was designed as the stenting group and 59 without stenting as control group. The differences between the two groups in complete response, complication and survival were analyzed.
The complete response rate of superior vena cava obstruction was 92.0% for the stenting group, and 42.0% for the control group, showing a significant difference between the two groups (P < 0.001). The median time to complete response was (3.76 ± 2.83) days in the stenting group, significantly shorter than that of the control group (28.08 ± 16.06) days (P < 0.001). The relapse rate after complete response was 12.0% in the stenting group and 16.0% in the control group, showing a non-significant difference between the two groups (P = 0.607). The median time to relapse was 2.7 months in the stenting group and 1.1 months in the control group (P = 0.533). In the stenting group, stent stenosis occurred in 1 case and thrombosis was observed in 3 cases. The incidence rate of complications was 6.3%. Thrombosis occurred in 1 case of the control group, with an incidence rate of complications of 1.7%, showing a non-significant difference between the two groups (P = 0.201). Seven among the 123 patients were still alive at the endpoint of following up. The median survival time was 8.0 months (stenting group) and 5.5 months (control group) (P = 0.382).
Endovascular stent insertion is effective and safe for non-small lung cell cancer patients with superior vena cava syndrome, and it may be recommended as the first choice for palliative treatment of superior vena cava obstruction.
评估血管内支架置入术治疗非小细胞肺癌合并上腔静脉综合征的有效性和安全性。
回顾性研究我院收治的123例非小细胞肺癌合并上腔静脉综合征患者。根据是否采用血管内支架置入术治疗上腔静脉综合征将患者分为两组。64例行血管内支架置入术的患者设为支架置入组,59例未行支架置入术的患者设为对照组。分析两组在完全缓解率、并发症及生存率方面的差异。
支架置入组上腔静脉梗阻的完全缓解率为92.0%,对照组为42.0%,两组间差异有统计学意义(P<0.001)。支架置入组完全缓解的中位时间为(3.76±2.83)天,显著短于对照组的(28.08±16.06)天(P<0.001)。完全缓解后的复发率在支架置入组为12.0%,对照组为16.0%,两组间差异无统计学意义(P = 0.607)。支架置入组复发的中位时间为2.7个月,对照组为1.1个月(P = 0.533)。支架置入组发生支架狭窄1例,观察到血栓形成3例。并发症发生率为6.3%。对照组发生血栓形成1例,并发症发生率为1.7%,两组间差异无统计学意义(P = 0.201)。123例患者中有7例在随访终点时仍存活。中位生存时间在支架置入组为8.0个月,对照组为5.5个月(P = 0.382)。
血管内支架置入术治疗非小细胞肺癌合并上腔静脉综合征有效且安全,可作为上腔静脉梗阻姑息治疗的首选方法。