论文部分内容阅读
目的探讨介入化疗与放疗或手术相结合治疗肺癌脑转移的临床效果。方法肺癌术后脑转移4例,首发脑转移症状并脑手术5例,肺癌脑转移20例。肺部用药:THP,MMC,DDP,5-Fu;脑部用药:DDP,VP16;用药前于该侧颈动脉注入10mg地塞米松+生理盐水共20mL,同时静脉快速滴注20%甘露醇250mL+10mg地塞米松;介入后第2天开始放疗,剂量为3000cGy/10次,2周,全脑两野对穿照射。结果肺部病灶25例中肿块明显缩小;脑部转移灶17例完成全程放疗,中位生存期8个月,最长生存1.5年。7例未能完成放疗,最长生存仅3个月。结论大部分脑转移均于肺部原发病灶治疗过程或治疗后发现,脑转移灶介入化疗后放疗,能减轻脑水肿,使病灶液化;能最大限度使血脑屏障开放,有利于药物进入脑病灶,其毒副作用时间短,使之与放疗相结合成为可能。
Objective To investigate the clinical effects of interventional chemotherapy combined with radiotherapy or surgery on brain metastases of lung cancer. Methods Four cases of postoperative brain metastases of lung cancer, five cases of brain metastases and brain surgery in 20 cases. Pulmonary drug: THP, MMC, DDP, 5-Fu; brain medication: DDP, VP16; before injection of 10mg dexamethasone + saline in the side of the carotid artery plus a total of 20mL, intravenous infusion of 20% mannitol 250mL +10 mg dexamethasone; radiotherapy was started on the second day after the intervention, with a dosage of 3000 cGy / 10 times for 2 weeks. Results 25 cases of lung lesions in the tumor was significantly reduced; 17 cases of brain metastases complete radiation therapy, the median survival of 8 months, the longest survival of 1.5 years. 7 cases failed to complete the radiotherapy, the longest survival of only 3 months. Conclusions Most of the brain metastases were found in the course of the treatment of primary lung lesions or after treatment. Brain metastases involve radiotherapy after chemotherapy, which can reduce cerebral edema and liquefy the lesions. It can maximize the opening of the blood-brain barrier and facilitate the entry of drugs into the brain Lesions, its short side effects, making it possible to combine with radiotherapy.