载药微球支气管动脉化疗栓塞术与传统支气管动脉化疗栓塞术治疗晚期非小细胞肺癌的对比研究
Drug-eluting beads bronchial arterial chemoembolization vs. conventional bronchial arterial chemoembolization in the treatment of advanced non-small cell lung cancer.
作者信息
Yu Guocan, Shen Yanqin, Chen Liangliang, Xu Xudong, Yang Jun
机构信息
Department of Thoracic Surgery, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Department of Nursing, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
出版信息
Front Med (Lausanne). 2023 Aug 3;10:1201468. doi: 10.3389/fmed.2023.1201468. eCollection 2023.
PURPOSE
To compare the effectiveness and safety of drug-eluting bead bronchial artery chemoembolization (DEB-BACE) with conventional bronchial artery chemoembolization (cBACE) and provide a novel treatment option for advanced non-small cell lung cancer (NSCLC).
METHODS
Patients with advanced NSCLC underwent DEB-BACE or cBACE and were screened retrospectively. Progression-free survival (PFS) and overall survival (OS) were the primary outcome indicators, while technical success rate, objective response rate (ORR), disease control rate (DCR), and adverse events (AEs) were the secondary ones.
RESULTS
A total of 41 patients were enrolled in the study, 12 in the DEB-BACE group and 29 in the cBACE group, according to the treatment regimen. No patient achieved complete response. Eighteen patients achieved partial response (9 in each group), 15 patients achieved stable disease (3 in the DEB-BACE group and 12 in the cBACE group), and eight patients achieved progressive disease (all in the cBACE group) when treated for 2 months. The overall ORR and DCR were 43.9% (18/41) and 80.5% (33/41), respectively. ORR and DCR in the DEB-BACE group were 50.0% (9/12) and 100.0% (12/12), respectively, while ORR and DCR in the cBACE group were 31.0% (9/29) and 72.4% (21/29), respectively. Compared to cBACE, the ORR and DCR of DEB-BACE were significantly improved ( < 0.05). The median PFS was better in the DEB-BACE group than in the cBACE group (6.95 months vs. 3.20 months, respectively, Hazard Ratio [HR] = 0.416; = 0.005). Furthermore, the median OS was significantly better in the DEB-BACE group than in the cBACE group (28.5 months vs. 22.5 months, respectively, HR = 0.316; = 0.020).
CONCLUSION
DEB-BACE has a good safety and therapeutic profile in advanced NSCLC and is superior to cBACE. DEB-BACE can be used as an alternative treatment option for advanced NSCLC, even in elderly patients.
目的
比较药物洗脱微球支气管动脉化疗栓塞术（DEB - BACE）与传统支气管动脉化疗栓塞术（cBACE）的有效性和安全性，为晚期非小细胞肺癌（NSCLC）提供一种新的治疗选择。
方法
对接受DEB - BACE或cBACE治疗的晚期NSCLC患者进行回顾性筛查。无进展生存期（PFS）和总生存期（OS）为主要观察指标，技术成功率、客观缓解率（ORR）、疾病控制率（DCR）和不良事件（AE）为次要观察指标。
结果
根据治疗方案，共有41例患者纳入研究，其中DEB - BACE组12例，cBACE组29例。无患者达到完全缓解。治疗2个月时，18例患者达到部分缓解（每组9例），15例患者病情稳定（DEB - BACE组3例，cBACE组12例），8例患者病情进展（均在cBACE组）。总体ORR和DCR分别为43.9%（18/41）和80.5%（33/41）。DEB - BACE组的ORR和DCR分别为50.0%（9/12）和100.0%（12/12），而cBACE组的ORR和DCR分别为31.0%（9/29）和72.4%（21/29）。与cBACE相比，DEB - BACE的ORR和DCR显著提高（<0.05）。DEB - BACE组的中位PFS优于cBACE组（分别为6.95个月和3.20个月，风险比[HR]=0.416；=0.005）。此外，DEB - BACE组的中位OS显著优于cBACE组（分别为28.5个月和22.5个月，HR = 0.316；=0.020）。
结论
DEB - BACE在晚期NSCLC中具有良好的安全性和治疗效果，优于cBACE。DEB - BACE可作为晚期NSCLC的替代治疗选择，即使是老年患者。
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