目的:探讨支气管动脉灌注培美曲塞和顺铂治疗局部晚期肺腺癌的疗效.方法:选取2015年1月—2016年6月安阳市肿瘤医院收治的局部晚期肺腺癌60例,以随机数字表法分为观察组和对照组,每组30例.对照组患者采用静脉滴注培美曲塞和顺铂进行化疗,观察组患者采用支气管动脉灌注培美曲塞和顺铂进行化疗,21 d为1个周期,两组患者均治疗3个周期.观察两组患者的临床疗效、不良反应发生情况,比较两组患者治疗前后的卡氏评分.结果:观察组患者的总有效率为86.67％(26/30),明显高于对照组的56.67％(17/30),差异有统计学意义(P0.05);观察组患者Ⅲ—Ⅳ级胃肠道反应、Ⅲ—Ⅳ级骨髓抑制的发生率分别为10.00％(3/30)、6.67％(2/30),明显低于对照组的30.00％(9/30)、26.67％(8/30),差异均有统计学意义(P0.05).结论:与静脉滴注相比,局部支气管动脉灌注培美曲塞和顺铂治疗局部晚期肺腺癌的疗效显著,可延长无进展生存期,减少胃肠道反应、骨髓抑制等不良反应发生概率.%OBJECTIVE:To probe into the efficacy of bronchial arterial infusion of pemetrexed and cis-platinum in treatment of locally advanced lung adenocarcinoma . METHODS: 60 patients with locally advanced lung adenocarcinoma admitted into Anyang Tumor Hospital from Jan .2015 to Jun .2016 were selected and divided into observation group and control group via random number table , with 30 cases in each .The control group was given intravenous drip of pemetrexed and cis-platinum for chemotherapy , while the observation group was given bronchial arterial infusion of pemetrexed and cis-platinum .Both groups received 3 courses of treatment , 21 days for each course . Clinical efficacy and incidences of adverse drug reactions of two groups were observed , differences in KPS scores between two groups before and after treatment were compared .RESULTS:The total effective rate of observation group (86.67％, 26/30 ) was significantly higher than that of the control group ( 56.67％, 17/30 ) , with statistically significant difference ( P 0.05);the incidences of Ⅲ-Ⅳ level of gastrointestinal reaction and Ⅲ-Ⅳ level of myelosuppression of observation group were respectively 10.00％ ( 3/30 ) and 6.67％( 2/30 ) , which were significantly lower than those of the control group ( 30.00％, 9/30;26.67％, 8/30), with statistically significant differences (P0.05 ) .CONCLUSIONS: Compared with that of intravenous drip , the efficacy of bronchial arterial infusion of pemetrexed and cis-platinum in treatment of locally advanced lung adenocarcinoma is more remarkable , which can prolong the progression-free survival , reduce adverse drug reactions including gastrointestinal reaction and myelosuppression .
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