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肺癌脑转移患者超选择性颅内动脉灌注化疗的临床探讨与应用

Clinical interrogation and application of super-selective intracranial artery infusion chemotherapy for lung cancer patients with brain metastases.

作者信息

Rong J, Chunhua M, Yuan L, Ning M, Jinduo L, Bin W, Liwei S

机构信息

Department of Intervention, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin 300060, China.

出版信息

Indian J Cancer. 2015 Nov;52 Suppl 1:e22-5. doi: 10.4103/0019-509X.168951.

Abstract

OBJECTIVE

The purpose of this study was to evaluate the clinical efficacy of super-selective intracranial artery infusion chemotherapy and to determine correlated prognostic parameters for advanced lung cancer patients with brain metastases.

PATIENTS AND METHODS

Fifty-four lung cancer patients with brain metastasis who had no previous treatment were enrolled for the study. These patients received super-selective intracranial artery infusion chemotherapy, as well as arterial infusion chemotherapy for primary and metastatic lesions. The procedure was performed once every 4 weeks. Patients were monitored to evaluate short-term clinical outcomes 4 weeks after the first 2 treatments, and follow-up visits performed every 4 weeks after the first 4 treatments until the appearance of disease progression or intolerable toxicity.

RESULTS

All 54 cases were treated at least 4 times. The overall response rate was 55.56% (30/54), and the disease control rate was 85.19% (46/54). The median overall survival was 7 months, with a 95% confidence interval (CI) of 5.87-8.13 months, and the median progression-free survival was 4 months, with a 95% CI of 3.20-4.80 months. The 6-month survival rate and 1-year survival rate were 81.48% (44/54) and 18.52% (10/54), respectively.

CONCLUSION

Super-selective intracranial artery infusion chemotherapy provides a clinically efficacious avenue of treatment for lung cancer patients with brain metastases. Pathological classification, Karnofsky performance status, and extracranial metastases may serve as reliable prognostic parameters in determining the clinical outcomes for lung cancer patients with brain metastases.

摘要

目的

本研究旨在评估超选择性颅内动脉灌注化疗的临床疗效,并确定晚期肺癌脑转移患者的相关预后参数。

患者与方法

54例未经治疗的肺癌脑转移患者纳入本研究。这些患者接受超选择性颅内动脉灌注化疗以及原发灶和转移灶的动脉灌注化疗。该操作每4周进行一次。在首次2次治疗后4周监测患者以评估短期临床结局,在首次4次治疗后每4周进行随访,直至出现疾病进展或不可耐受的毒性反应。

结果

所有54例患者均至少接受4次治疗。总缓解率为55.56%(30/54),疾病控制率为85.19%(46/54)。中位总生存期为7个月,95%置信区间(CI)为5.87 - 8.13个月,中位无进展生存期为4个月,95%CI为3.20 - 4.80个月。6个月生存率和1年生存率分别为81.48%(44/54)和18.52%(10/54)。

结论

超选择性颅内动脉灌注化疗为肺癌脑转移患者提供了一种临床有效的治疗途径。病理分类、卡氏功能状态评分和颅外转移可能是确定肺癌脑转移患者临床结局的可靠预后参数。

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