Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 May;13(5):540-3.
doi: 10.3779/j.issn.1009-3419.2010.05.29.

[Analysis of 41 cases of primary hypervascular non-small cell lung cancer treated with embolization of emulsion of chemotherapeutics and iodized oil]

[Article in Chinese]
Lingfei Luo  1 , Hongwu Wang, Hongming Ma, Hang Zou, Dongmei Li, Yunzhi Zhou
Affiliations

[Analysis of 41 cases of primary hypervascular non-small cell lung cancer treated with embolization of emulsion of chemotherapeutics and iodized oil]

[Article in Chinese]
Lingfei Luo et al. Zhongguo Fei Ai Za Zhi. 2010 May.

Abstract
in English, Chinese

Background and objective: Transcatheter arterial chemotherapy and embolization is the main method in the treatment of lung cancer, but most of the reports do not study individually to small cell lung cancer (SCLC), non-small cell lung cancer (NSCLC), hypovascular and hypervascular lung cancer. The pre-embolization perfusion of hemotherapeutics is still being used routinely and seldom report to iodized oil embolization. The article summarized the quality of life after the treatment, clinical efficiency, survival time and complications to evaluate the clinical effect of primary hypervascular NSCLC treated with embolization of emulsion of chemotherapeutics and iodized oil.

Methods: The study totally analyzed 41 cases which confirmed by pathology and follow up study from January, 2008 to January 2009. The CT scan with IV contrast demonstrates over moderate enhanced lesion which indicate hypervascular. Within the 41 cases, 23 cases of central, 18 cases of peripheral. Suqamous carcinoma 21 cases, adenocarcinoma 15 cases and squamoadenocarcinoma 5 cases. Stage IIIb 34 cases, stage IV 7 cases. Superselective incubation with microcatheter under DSA, to embolize the capillary bed with liquefied iodized oil and the emulsion of pharmorubicin, to embolize the supply artery of the tumor with gelatin foam microparticle. The liquefied iodized oil 5 mL-10 mL, pharmorubicin 10 mg-30 mg. The longest follow up is 12 months and to compare with the references of 2007-2009.

Results: The KPS is widely acclaimed after the treatment (P < 0.05), no complete response (CR), 31 cases of partial response (PR), 7 cases of no change (NC) and 3 cases of progressive disease (PD), the total efficiency (CR+PR) is 75.6%. The clinical efficiency (CR+PR+NC) is 92.68%. 33 cases of total survival tome over 12 months (80.48%), IIIb stage 29/34 (85.29%), IV stage 4/7 (57.14%). 1 case with severe complication-spinal injury.

Conclusion: To treat primary hypervascular NSCLC with simple embolization of emulsion of chemotherapeutics and iodized oil is very useful and can avoid the side effect of chemotherapeutics. The key point to avoid spinal injury and other severe complications is to distinguish the spinal aretery and intratumor AV fistula by using superselective incubation with microcatheter under DSA.

背景与目的: 动脉内化疗、栓塞是治疗肺癌的主要手段，但多数报道并未将小细胞肺癌与非小细胞肺癌、乏血型肺癌与富血型肺癌区分开来做进一步研究，栓塞前的化疗药灌注一直延用，对碘化油栓塞报道很少。本文通过对患者治疗后生存质量、临床有效率、生存期以及并发症进行总结，旨在探讨碘化油化疗药乳剂栓塞治疗原发性富血型非小细胞肺癌的临床疗效。

方法: 2008年1月-2009年1月经病理证实并完成随访的患者41例，CT增强扫描病灶中等度以上强化，提示血供丰富。包括中央型23例，周围型18例，鳞癌21例，腺癌15例，腺鳞癌5例；Ⅲb期34例，Ⅳ期7例。使用微导管在DSA下做靶动脉超选择插管，以液态碘化油+表阿霉素乳剂栓塞肿瘤毛细血管床，以明胶海绵微粒栓塞肿瘤供血动脉，液态碘化油用量5 mL-10 mL，表阿霉素10 mg-30 mg。最长随访12个月并与2007年-2009年相关文献进行对比。

结果: 治疗后患者症状改善，KPS显著提高（P < 0.05），局部病灶完全缓解（complete response, CR）0例，部分缓解（partial response, PR）31例，无变化（no change, NC）7例，疾病进展（progressive disease, PD）3例，总有效率（CR+PR）75.60%，临床受益率（CR+PR+NC）92.68%。总生存期超过12个月者33例（80.48%），Ⅲb期29/34（85.29%），Ⅳ期4/7（57.14%）。并发症脊髓损伤1例。

结论: 碘化油+化疗药乳剂单纯栓塞治疗原发性富血型非小细胞肺癌临床疗效肯定，同时避免化疗药毒副反应。DSA下使用微导管做绝对的超选择插管并仔细区分脊髓动脉以及肿瘤内动静脉瘘是避免脊髓损伤等严重并发症的关键。

PubMed Disclaimer

Figures

1
1
左下叶腺癌单纯碘化油乳剂栓塞化疗。A：左侧支气管动脉DSA显示肿瘤浓染；B：微导管超选择插管后栓塞化疗；C：治疗后CT显示肿瘤内碘化油浓聚 Adenocarcinoma of left inferior lobe with simple embolization of emulsion of chemotherapeutics and iodized oil. A: Left bronchial artery DSA demonstates conspicuous tumor stain; B: Embilization and chemotherapy after superselective incubation with microcatheter; C: After the treatment, CT demonstrates iodized oil collection in tumor
2
2
右上叶鳞癌单纯碘化油乳剂栓塞化疗。A：右侧支气管动脉与肋间动脉共干，支气管动脉远端见肿瘤血管及染色；B：微导管超选择插管后栓塞化疗；C：肿瘤血管栓堵后肋间动脉干大量紊乱纤细血管支充盈 Squamocarcinoma of left superior lobe with simple embolization of emulsion of chemotherapeutics and iodized oil. A: Right bronchial artery and intercostals artery share one trunk, the distal area of bronchial aretery demonstrates tumor artery and tumor stain; B: Embilization and chemotherapy after superselective incubation with microcatheter; C: After the embolization, the trunk of intercostal artery demonstrates plenty of disorganized branches filling
3
3
右上叶中央型鳞癌。右侧支气管动脉与肋间动脉共干，肋间动脉干同时见扭曲血管支充盈 Central squamocarcinoma of right superior lobe. Right bronchial artery and intercostals artery share one trunk, some tortuous branches of the trunk of intercostals artery filling
4
4
左上叶腺癌单纯碘化油乳剂栓塞化疗。A：微导管超选择插管后栓塞化疗；B（上）：肿瘤治疗前；B（下）：治疗后4个月复查肿瘤内碘化油浓聚，瘤体缩小 Adenocarcinoma of left superior lobe with simple embolization of emulsion of chemotherapeutics and iodized oil. A: Embilization and chemotherapy by superselective incubation with microcatheter; B (top): pre-treatment; B (bottom): Follow up 4 months after treatment, CT demonstrates iodized oil collection in tumor and the tumor become smaller
See this image and copyright information in PMC

References

    1. Yang J. Current status in endovascular interventional therapy of lung cancer. http://www.cnki.com.cn/Article/CJFDTOTAL-WCYX200805036.htm J Minim Invasive Med. 2008;3(5):486–488.
    2. 杨 健. 肺癌的血管性介入治疗现状. http://www.cnki.com.cn/Article/CJFDTOTAL-WCYX200805036.htm 微创医学. 2008;3(5):486–488.
    1. Xu HF, Yang RJ. Current status in interventional treatment of lung cancer through bronchial artery. http://med.wanfangdata.com.cn/Paper/Detail/PeriodicalPaper_syfsxzz200805038 J Pract Radiol. 2008;24(5):701–702.
    2. 徐 海峰, 杨 仁杰. 肺癌支气管动脉介入治疗的现状. http://med.wanfangdata.com.cn/Paper/Detail/PeriodicalPaper_syfsxzz200805038 实用放射学杂志. 2008;24(5):701–702.
    1. Yang XZ, Yang L, Chen ZQ, et al. Causes and strategy of spinal cord injury in bronchial arteries interventional for the lung diseases. http://d.old.wanfangdata.com.cn/Periodical/zgjryxyzlx200806006 Chin J Intervent Imag Ther. 2008;5(6):429–431.
    2. 杨 熙章, 杨 利, 陈 自谦, et al. 支气管动脉化疗栓塞术导致脊髓损伤的原因与对策. http://d.old.wanfangdata.com.cn/Periodical/zgjryxyzlx200806006 中国介入影像与治疗学. 2008;5(6):429–431.
    1. Zhou J, Yuan JH, Yu WQ, et al. Bronchial arterial chemoembo lization with ADM-lipiodal mixture in the treatment of brochogenic carcinoma. http://d.old.wanfangdata.com.cn/Periodical/jrfsxzz200701009 J Intervent Radiol. 2007;16(1):32–34.
    2. 周 俊, 袁 建华, 俞 文强, et al. 支气管动脉碘化油化疗栓塞肺癌. http://d.old.wanfangdata.com.cn/Periodical/jrfsxzz200701009 介入放射学杂志. 2007;16(1):32–34.

    1. Wu PH, Huang JH, Luo PF, et al. ed. Interventional diagnosis and treatment in inoncplogy. 1st ed. Beijing: Science Press, 2005. 557-598.

    2. 吴沛宏, 黄金华, 罗鹏飞, 等. 主编. 肿瘤介入诊疗学. 第1版. 北京: 科学出版社, 2005. 557-598.

Publication types