肺癌并发上腔静脉综合征的临床综合治疗方案及疗效观察
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摘要
目的观察肺癌并发上腔静脉综合征的临床综合治疗方案及疗效。方法随机选取2013年2月~2015年2月我院收治的肺癌并发上腔静脉综合征患者60例,依据治疗方法将患者分为综合治疗组(介入治疗+适形放疗+常规化疗,n=30)和常规化疗组(n=30),对两组患者的临床疗效、不良反应发生情况、6个月、1年、2年、3年生存情况进行统计分析。结果综合治疗组患者的总缓解率为86.7%(26/30),显著高于常规化疗组的60.0%(18/30)(P<0.05);综合治疗组患者的6个月、1年、2年、3年生存率分别为96.7%(29/30)、83.3%(25/30)、66.7%(20/30)、53.3%(16/30)均显著高于常规化疗组80.0%(24/30)、63.3%(19/30)、46.7%(14/30)、33.3%(10/30),差异有统计学意义(P<0.05)。结论肺癌并发上腔静脉综合征患者采取综合治疗较常规化疗疗效显著。
Objective To observe the comprehensive treatment and efficacy of patients with lung cancer complicated with superior vena cava syndrome. Methods 60 patients with lung cancer complicated with superior vena cava syndrome treated in our hospital from February 2013 to February 2015 were randomly selected and divided into comprehensive treatment group(interventional therapy+conformal radiotherapy+conventional chemotherapy, n=30) and conventional chemotherapy group(n=30) according to treatment method. The clinical efficacy, occurrence of adverse reactions,and survival at 6 months, 1 year, 2 years, and 3 years of the two groups were statistically analyzed. Results The total remission rate of patients in the comprehensive treatment group(86.7%, 26/30) was significantly higher than that of the conventional chemotherapy group(60.0%, 18/30)(P<0.05). The 6 months, 1 year, 2 years, and 3 years survival rate were 96.7%(29/30), 83.3%(25/30), 66.7%(20/30), 53.3%(16/30) respectively of the conventional chemotherapy group were all significantly higher than those of conventional chemotherapy group[80.0%(24/30), 63.3%(19/30), 46.7%(14/30),33.3%(10/30)], the difference was statistically significant(P<0.05). Conclusion Comprehensive treatment in patients with lung cancer complicated with superior vena cava syndrome is more effective than conventional chemotherapy.
Objective To observe the comprehensive treatment and efficacy of patients with lung cancer complicated with superior vena cava syndrome. Methods 60 patients with lung cancer complicated with superior vena cava syndrome treated in our hospital from February 2013 to February 2015 were randomly selected and divided into comprehensive treatment group(interventional therapy+conformal radiotherapy+conventional chemotherapy, n=30) and conventional chemotherapy group(n=30) according to treatment method. The clinical efficacy, occurrence of adverse reactions,and survival at 6 months, 1 year, 2 years, and 3 years of the two groups were statistically analyzed. Results The total remission rate of patients in the comprehensive treatment group(86.7%, 26/30) was significantly higher than that of the conventional chemotherapy group(60.0%, 18/30)(P<0.05). The 6 months, 1 year, 2 years, and 3 years survival rate were 96.7%(29/30), 83.3%(25/30), 66.7%(20/30), 53.3%(16/30) respectively of the conventional chemotherapy group were all significantly higher than those of conventional chemotherapy group[80.0%(24/30), 63.3%(19/30), 46.7%(14/30),33.3%(10/30)], the difference was statistically significant(P<0.05). Conclusion Comprehensive treatment in patients with lung cancer complicated with superior vena cava syndrome is more effective than conventional chemotherapy.
引文
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[2]李芳娟,孙希文,梁世雄,等.血管内支架治疗非小细胞肺癌合并上腔静脉综合征的疗效[J].中华肿瘤杂志,2015,37(1):47-51.
[3]徐鹏飞,李孟,黄辉.46例肺癌合并上腔静脉综合征的临床分析[J].现代肿瘤医学,2015,23(11):1528-1530.
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[6]葛方红,谢国栋,顾红芳,等.综合疗法治疗肺癌合并上腔静脉综合征19例临床观察[J].浙江临床医学,2015,17(1):57-58.
[7]邬亚红,陈文宇,水小芳,等.自我效能感在肺癌疼痛患者护理中的应用效果研究[J].中国现代医生,2017,55(8):149-152.
[8]朱凤娇,潘连连,王传捷,等.支气管肺泡灌洗液T淋巴细胞亚群及肿瘤标志物检测在肺癌诊断中的应用价值[J].中国现代医生,2017,55(35):132-135.
[9]Khalifa M,Patel N,Moser S.Superior vena cava obstruction complicated by upper extremity deep vein thrombosis:A novel endovascular approach[J].Vasc Endovascular Surg,2016,50(3):180-182.
[10]Zhang J,Tang S,Hu C,et al.Femorally inserted central venous catheter in patients with superior vena cava obstruction:Choice of the optimal exit site[J].J Vasc Access,2017,18(1):82-88.
[11]Batra S,Doval DC,Batra U,et al.Gallbladder cancer with tumor thrombus in the superior vena cava[J].Hepatobiliary Pancreat Dis Int,2010,9(3):325-328.
[12]Jung B,Murgu S,Colt H.Rigid bronchoscopy for malignant central airway obstruction from small cell lung cancer complicated by SVC syndrome[J].Ann Thorac Cardiovasc Surg,2011,17(1):53-57.
[13]Ampil FL,Caldito G.Patient-provider delays in superior vena caval obstruction of lung cancer and outcomes[J].Am J Hosp Palliat Care,2014,31(4):441-443.
[14]Zhang X,Li X,Meng M,etal.Vascular spinal cord obstruction associated with superior vena cava syndrome:A case report and literature review[J].Medicine(Baltimore),2017,96(51):e9196.
[15]Galetta D,Spaggiari L.Early and long-term results of tracheal sleeve pneumonectomy for lung cancer after induction therapy[J].Ann Thorac Surg,2018,105(4):1017-1023.
[2]李芳娟,孙希文,梁世雄,等.血管内支架治疗非小细胞肺癌合并上腔静脉综合征的疗效[J].中华肿瘤杂志,2015,37(1):47-51.
[3]徐鹏飞,李孟,黄辉.46例肺癌合并上腔静脉综合征的临床分析[J].现代肿瘤医学,2015,23(11):1528-1530.
[4]张伟,管峦,殷海涛,等.血管内支架置入联合放疗治疗肺癌合并上腔静脉综合征的临床观察[J].临床肿瘤学杂志,2013,18(3):249-251.
[5]牛慧彦,李慧,王佳贺,等.Rho GDI2与PI3K/Akt/m TOR信号通路在肺癌细胞中的相关性研究[J].中国组织化学与细胞化学杂志,2011,20(2):107-111.
[6]葛方红,谢国栋,顾红芳,等.综合疗法治疗肺癌合并上腔静脉综合征19例临床观察[J].浙江临床医学,2015,17(1):57-58.
[7]邬亚红,陈文宇,水小芳,等.自我效能感在肺癌疼痛患者护理中的应用效果研究[J].中国现代医生,2017,55(8):149-152.
[8]朱凤娇,潘连连,王传捷,等.支气管肺泡灌洗液T淋巴细胞亚群及肿瘤标志物检测在肺癌诊断中的应用价值[J].中国现代医生,2017,55(35):132-135.
[9]Khalifa M,Patel N,Moser S.Superior vena cava obstruction complicated by upper extremity deep vein thrombosis:A novel endovascular approach[J].Vasc Endovascular Surg,2016,50(3):180-182.
[10]Zhang J,Tang S,Hu C,et al.Femorally inserted central venous catheter in patients with superior vena cava obstruction:Choice of the optimal exit site[J].J Vasc Access,2017,18(1):82-88.
[11]Batra S,Doval DC,Batra U,et al.Gallbladder cancer with tumor thrombus in the superior vena cava[J].Hepatobiliary Pancreat Dis Int,2010,9(3):325-328.
[12]Jung B,Murgu S,Colt H.Rigid bronchoscopy for malignant central airway obstruction from small cell lung cancer complicated by SVC syndrome[J].Ann Thorac Cardiovasc Surg,2011,17(1):53-57.
[13]Ampil FL,Caldito G.Patient-provider delays in superior vena caval obstruction of lung cancer and outcomes[J].Am J Hosp Palliat Care,2014,31(4):441-443.
[14]Zhang X,Li X,Meng M,etal.Vascular spinal cord obstruction associated with superior vena cava syndrome:A case report and literature review[J].Medicine(Baltimore),2017,96(51):e9196.
[15]Galetta D,Spaggiari L.Early and long-term results of tracheal sleeve pneumonectomy for lung cancer after induction therapy[J].Ann Thorac Surg,2018,105(4):1017-1023.