Seki Akihiko, Shimono Chigusa
Department of Medical Oncology, Suita Tokushukai Hospital, 21-1 Senriokanishi, Suita, Osaka, 565-0814, Japan.
Jpn J Radiol. 2017 Sep;35(9):495-504. doi: 10.1007/s11604-017-0659-2. Epub 2017 Jun 12.
To evaluate the hemostatic effects of transarterial infusion chemotherapy in addition to embolization (chemoembolization) for advanced primary lung cancer with tumor-related hemoptysis.
Ten consecutive patients with stage IIIB/IV or recurrent primary lung cancer (squamous cell carcinoma in six, adenocarcinoma in four) who underwent chemoembolization for control of hemoptysis were enrolled. At enrollment, five patients were considered refractory and five had contraindications to standard therapies. The amount of hemoptysis was massive in two patients, moderate in seven, and slight in one. Transarterial infusion chemotherapy via feeding arteries using cisplatin (25 mg/m) and 5-fluorouracil (300 mg/m) was repeated every 3-4 weeks for three cycles. HepaSphere (100-150 µm) or gelatin sponge particles were selected as embolic materials depending on the presence of pulmonary shunts and were added for embolization just after drug infusion.
Hemoptysis improved in all patients (resolution in nine, significant decrease in one). The median hemostasis time was 11.9 months (range 2.7-25.9 months). The target pulmonary lesions shrank in seven patients, and pulmonary atelectasis disappeared in three of five patients.
Chemoembolization may be a palliative option with favorable hemostasis time for advanced primary lung cancer with hemoptysis.
评估经动脉灌注化疗联合栓塞术（化疗栓塞术）对伴有肿瘤相关性咯血的晚期原发性肺癌的止血效果。
连续纳入10例接受化疗栓塞术以控制咯血的ⅢB/Ⅳ期或复发性原发性肺癌患者（鳞状细胞癌6例，腺癌4例）。入组时，5例患者被认为是难治性的，5例有标准治疗的禁忌证。咯血程度为大量2例，中度7例，轻度1例。经供血动脉使用顺铂（25mg/m）和5-氟尿嘧啶（300mg/m）进行经动脉灌注化疗，每3 - 4周重复一次，共三个周期。根据肺分流情况选择HepaSphere（100 - 150μm）或明胶海绵颗粒作为栓塞材料，并在药物输注后立即进行栓塞。
所有患者咯血均有改善（9例缓解，1例显著减轻）。中位止血时间为11.9个月（范围2.7 - 25.9个月）。7例患者的目标肺部病变缩小，5例患者中有3例肺不张消失。
化疗栓塞术对于伴有咯血的晚期原发性肺癌可能是一种具有良好止血时间的姑息性选择。
