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目的通过对不能切除的和(或)复发的胸膜间皮瘤病人行非选择性经动脉化学灌注治疗,将其作为姑息性治疗的一种选择,测定治疗后的平均体积、生存期和病人症状的改变来评估肿瘤反应。材料与方法医院伦理委员会批准了这一回顾性研究,所有病人在进行治疗前均签署知情同意书。39例无法手术切除的恶性胸膜间皮瘤的病人(女10例,男29例;平均年龄64.0岁)在2007年3月—2010年3月间行多次经动脉化学灌注治疗,平均每例病人每4周治疗2.9次。用丝裂霉素C、顺铂和吉西他滨进行经动脉化学灌注治疗。对CT表现和病人症状进行评估。用实体瘤治疗疗效评价标准对肿瘤反应进行评估,用Kaplan-Meier法对生存期进行估计。部分反应组的体积变化用Wilcoxon符号秩检验进行验证。结果治疗后肿瘤的36%(14/39)达到部分反应,且肿瘤体积从(839.6±590.3)mL(3.9~1972.2mL)减少到(137±399.8)mL(0.88~1131.4;P=0.00012)。49%的肿瘤(19/39)病变较为稳定。15%的肿瘤(6/49)为进展性疾病。肿瘤的平均明确生长速率为每天0.00158%。从治疗开始时,平均生存时间为14.2个月(2.1~33.1个月)。对于治疗有反应的肿瘤病人,平均生存时间为15个月(4.5~33.1个月)。对于所有肿瘤,疾病进展的平均时间为2.6个月,稳定性病变为1.5个月,进展性疾病为1.3个月。结论经动脉化学灌注疗法在治疗复发性和(或)不可切除的恶性胸膜间皮瘤中可能产生潜在的阳性结果和反应。
OBJECTIVE: To determine the mean volume, survival, and patient status after treatment by non-selective transarterial chemoembolization of unresectable and / or recurrent pleural mesothelioma patients as an option for palliative treatment The changes to assess the tumor response. MATERIALS AND METHODS The Hospital Ethics Committee approved this retrospective study, and all patients signed informed consent prior to treatment. 39 cases of unresectable malignant pleural mesothelioma patients (10 males and 29 females; average age 64.0 years old) in March 2007 - March 2010 were performed multiple arterial infusion chemotherapy, the average of each case The patient was treated 2.9 times every 4 weeks. Arterial chemical perfusion with mitomycin C, cisplatin and gemcitabine. CT findings and patient symptoms were assessed. Tumor response was evaluated using a solid tumor evaluation criteria for treatment efficacy, and Kaplan-Meier survival was estimated. The volume changes of some reaction groups were verified by the Wilcoxon signed-rank test. Results 36% (14/39) of the tumors achieved partial response after treatment and the tumor volume decreased from (839.6 ± 590.3) mL (3.9 ~ 1972.2 mL) to (137 ± 399.8) mL (0.88 ~ 1131.4; P = 0.00012). 49% of the tumors (19/39) are more stable. 15% of the tumors (6/49) are progressive disease. The average clear tumor growth rate was 0.00158% per day. From the start of treatment, the mean survival time was 14.2 months (2.1 to 33.1 months). The average survival time for treatment-responsive tumor patients was 15 months (4.5 to 33.1 months). The mean time to disease progression was 2.6 months for all tumors, 1.5 months for stable disease, and 1.3 months for progressive disease. Conclusions Transarterial chemical perfusion therapy may produce potentially positive results and responses in the treatment of recurrent and / or unresectable malignant pleural mesothelioma.