肺癌：支气管动脉化疗性栓塞_杨宁肿瘤介入医学网

从60,70年代发展起来的这一技术，差不多算是一项古老的技术，曾经被证明对生存率没有影响的技术，几十年过去了，如今它

- Is it logical?

- Is it dangerous?

- Is it effective?

Are there any study is to clarify these interrogative points（疑问点） and to develop a new treatment method for primary lung cancer.


primary lung cancer	CT Study

Treatment method


Guiding catheter: 4 Fr. cobra shape, shepherd hook	Angio-CT hybrid suits	Chemo-agents & Embolic Material


CT Study	Catheter insertion to the bronchial artery and DSA study

	Anti-neoplastic agents: CDDP;20-50mg, 5-FU;250-300mg Embolic material: Hepasphere（100‐150 μm);25mg Actual diameter:200-300 μm
Arterial infusion CT:CM injection: 2.0 – 8.0 mL, 0.2 – 0.4 mL/sec	Chemo-infusion and Embolization;；End point: stasis or slow down of blood flow

CT follow-up： One month after the treatment	Repetition of treatment：Once a month if effective

Is BACE a logical method ?

Circulation to the pulmonary lesion

Feasibility of bronchial arterial catheterization

Degree of Enhancement of the lesion on DSA and arterial infusion CT

Is it dangerous ?

Complications of bronchial chemo-infusion and embolization

Procedure related complications

Spinal arterial circulation

Is it effective ?

Treatment effects

Treatment effect was evaluated after three sessions by CT exams.

RECIST criteria was used to evaluate the treatment effect

完全染色的病变（Total enhancement of the lesion）


Primary lung cancer：T2N1M1	Poorly deff. adenocarcinoma

Bronchial angiography shows tumor brash corresponding to the lesion.	Arterial infusion CT：The pulmonary lesion was totally enhanced. The lymph node metastases was simultaneously enhanced.

Post BACE （after 3 sessions）	Follow-up CT examination showed marked regression of the primary lesion. Respiratory symptom has improved.


Adenocarcinoma	Bronchial arteriography

Arterial infusion CT	CT follow-up in 3 months

部分染色的病变（Partial enhancement of the lesion）

	Primary lung cancer T2N0M0 Non-small cell lung cancer

Bronchial angiography shows tumor brash corresponding to the lesion.	The pulmonary lesion was partially enhanced.The defect area (→) could be fed by the other branches.

Post BACE：Treatment effect was SD.	The 3ed session：The area treated in the first session was reduced, however, the untreated area (→ ) had progressively increased .

Ring enhancement of the lesion




Primary lung cancer：T2N0M0；Bronchial arteriography did not show the enhancement of the tumor, however, arterial infusion CT demonstrated a ring and marginal enhancement of the tumor. The intercostal artery was originated from the right bronchial artery (→ )	The circulation to the spinal cord was visualized in the arterial infusion CT ( →)

Is it logical ?

primary lung cancer in the lung field is fed by the bronchial artery. Chemo-infusion into the bronchial artery followed by the embolization is a logical treatment method.

Is it dangerous ?

There was neither procedure related complication nor chemo-agent related side effects. The spinal circulation was safely avoided by the use of the arterial infusion CT.

Is it effective ?

The local control rate in three months was 8/9 ( 89%).

Bronchial arterial chemo-embolization is a safe and effective method to control growth of pulmonary cancer with minimum complications.

尽管如此，一个治疗手段的有效性，主要是有质量的寿命年/钱

疗效的判定的包括
近期疗效的判定：客观反应率ORR
远期疗效的判定：OS

COST-EFFECT

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肺癌：支气管动脉化疗性栓塞