支气管动脉化疗栓塞与全身静脉化疗治疗中晚期非小细胞肺癌的临床效果比较

摘要/Abstract

摘要： 目的比较中晚期非小细胞肺癌（NSCLC）患者给予支气管动脉化疗栓塞（BACE）与全身静脉化疗治疗的临床效果。方法选取2017年10月—2023年1月德州市陵城区中医院收治的中晚期NSCLC患者共计64例,以随机数表法分成观察组（32例）与对照组（32例）。观察组给予BACE治疗,对照组给予全身静脉化疗治疗,比较两组临床疗效、血清肿瘤标志物、炎症因子、生活质量、安全性、成本-效益,统计1年生存率。结果观察组客观缓解率（ORR）、疾病控制率（DCR）较对照组更高（P<0.05）;治疗后两组糖类抗原125（CA125）、癌胚抗原（CEA）、糖类抗原19-9（CA19-9）水平下降（P<0.05）,观察组较对照组更低（P<0.05）;治疗后两组肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）、白细胞介素-8（IL-8）水平下降（P<0.05）,观察组较对照组更低（P<0.05）;治疗后两组Karnofsky功能状态评分标准（KPS）评分升高（P<0.05）,观察组较对照组更高（P<0.05）;观察组不良反应（骨髓抑制、消化道反应、贫血）发生率较对照组更低（P<0.05）,观察组未出现肺栓塞等严重并发症,1例出现出血,经内科治疗后出血停止;统计1年生存率,观察组较对照组更高（P<0.05）;观察组成本效益比优于对照组。结论对于中晚期NSCLC患者,与全身静脉化疗相比,BACE治疗能够提升临床疗效,调节血清肿瘤标志物、炎症因子水平,提高生活质量,提高患者1年生存率,安全性较高,成本-效益更佳。

关键词: 中晚期非小细胞肺癌, 支气管动脉化疗栓塞, 全身静脉化疗, 血清肿瘤标志物, 炎症因子

Abstract: Objective To compare the clinical efficacy of bronchial artery chemoembolization (BACE) and systemic intravenous chemotherapy in patients with mid to late stage non-small cell lung cancer (NSCLC). Methods A total of 64 patients with mid to late stage NSCLC from October 2017 to January 2023 who were admitted in Lingcheng District Traditional Chinese Medicine Hospital in Dezhou city were selected. By random number table method, they were divided into the observation group (32 cases, BACE) and the control group (32 cases, systemic intravenous chemotherapy). The clinical efficacy, serum tumor markers, inflammatory factors, quality of life, safety, cost-effectiveness, and one-year survival rate in both groups were compared. Results In the Objective response rate (ORR) and disease control rate (DCR), in comparison of the control group, the observation group were higher (P<0.05). After treatment, the carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA19-9) levels in both groups were decreased (P<0.05), and in comparison of the control group, the observation group was lower (P<0.05). After treatment, the tumor necrosis factors- α (TNF- α), C-reactive protein (CRP) and interleukin-8 (IL-8) levels were decreased in both groups (P<0.05), and in comparison of the control group, the observation group was lower (P<0.05). After treatment, the Karnofsky functional status score (KPS) in both groups were increased (P<0.05), and in comparison of the control group, the observation group was higher (P<0.05). In the incidence of adverse reactions (bone marrow suppression, gastrointestinal reactions, anemia), in comparison of the control group, the observation group was lower (P<0.05). There were no serious complications such as pulmonary embolism in the observation group, and one case experienced bleeding. After internal medicine treatment, the bleeding stopped. In the one-year survival rate, in comparison of the control group 62.50% (20/32), the observation group 88.00% (22/25) was higher (P<0.05). The cost-effectiveness ratio of the observation group was better than that of the control group. Conclusion For patients with mid to late stage NSCLC, compared with systemic intravenous chemotherapy, BACE treatment can improve clinical efficacy, regulate serum tumor markers and inflammatory factor levels, improve quality of life, improve 1-year survival rate, and with high safety, achieve better cost-effectiveness.

Key words: mid to late stage non-small cell lung cancer, bronchial artery chemoembolization, systemic intravenous chemotherapy, serum tumor markers, inflammatory factors

中图分类号:

R734.2

张志辉. 支气管动脉化疗栓塞与全身静脉化疗治疗中晚期非小细胞肺癌的临床效果比较[J]. 中华养生保健, 2025, 43(5): 51-55.

ZHANG Zhi-hui. Comparison of Clinical Efficacy between Bronchial Artery Chemoembolization and Systemic Intravenous Chemotherapy in the Treatment of Mid to Late Stage Non-Small Cell Lung Cancer[J]. ZHONGHUA YANGSHENG BAOJIAN, 2025, 43(5): 51-55.

参考文献

[1] 许香贵. 华蟾素片联合DP化疗方案治疗中晚期非小细胞肺癌对患者免疫功能、血清肿瘤标志物水平影响[J].中国医学创新,2023,20(32):134-137.
[2] 徐建群,王红娟,郭红荣,等.贝伐单抗结合培美曲塞与顺铂化疗对非小细胞肺癌患者血清lncRNA H19及lncRNA HOTAIR表达的影响[J].中国老年学杂志,2023,43(2):283-287.
[3] 赖林强,涂建飞,陈炜越,等.支气管动脉化疗栓塞与静脉化学治疗中晚期肺癌的临床效果[J].介入放射学杂志,2023,32(3):233-236.
[4] 朱云飞,黄梦洁,刘圣斌.支气管动脉灌注化疗联合栓塞术治疗PS评分≥2分晚期NSCLC患者的临床效果[J].临床合理用药杂志,2024,17(12):21-24.
[5] 支修益,石远凯,于金明.中国原发性肺癌诊疗规范(2015年版)[J].中华肿瘤杂志,2015,37(1):67-78.
[6] EISENHAUER E A, THERASSE P, BOGAERTS J, et al.New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1)[J].Eur J Cancer,2009,45(2):228-247.
[7] KARNOFSKY D A, BURCHENAL J H.The clinical evaluation of chemotherapeutic agents in cancer. In: MacLeod CM(Ed). Evaluation of Chemotherapeutic Agents[M].New York:Columbia University Press,1949:196.
[8] 程瑞文,郝若冰,李平,等.CalliSpheres药物洗脱微球和空白微球经动脉化疗栓塞术治疗中晚期非小细胞肺癌的比较[J].实用医学杂志,2024,40(1):32-37.
[9] 王春萍,李薇,崔鑫,等.脾多肽注射液联合化疗治疗中晚期非小细胞肺癌的药物经济学评价[J].中国医院药学杂志,2023,43(5):525-529.
[10] 鲁志刚,王薇,孙嘉阳.支气管动脉化疗栓塞术联合贝伐珠单抗治疗中晚期非小细胞肺癌的临床效果及对血浆微小RNA-200a和微小RNA-375表达水平的影响[J].中国医药,2023,18(8):1145-1149.
[11] 辛鑫,梁志伟,余会敏,等.支气管动脉化疗栓塞术联合贝伐珠单抗治疗中晚期非小细胞肺癌患者的疗效及其对血浆miR-200a和miR-375表达水平的影响研究[J].实用心脑肺血管病杂志,2022,30(4):37-41.
[12] 王兆映,杨培培,袁牧,等.支气管动脉化疗栓塞介入治疗非小细胞肺癌患者的临床效果研究[J].中国现代医药杂志,2023,25(10):37-41.
[13] 付文兴. 肺癌患者应用支气管动脉化疗栓塞术的安全性和有效性分析[J].黑龙江医药科学,2023,46(5):74-76.
[14] 昌敏,刘仲韬,赵凡杰,等.白蛋白紫杉醇联合顺铂治疗中晚期非小细胞肺癌患者的疗效及其对炎症反应、NLR及PLR水平的影响[J].临床和实验医学杂志,2023,22(17):1820-1825.
[15] 郑晓霆,景文冬,时广伟,等.大剂量支气管动脉灌注化疗栓塞与全身静脉化疗治疗晚期非小细胞肺癌疗效的对比研究[J].现代医学,2023,51(2):216-219.