背景:支气管动脉栓塞术(BAE)是控制原发性肺癌咯血的有效治疗选择。然而,尚无研究调查肺癌患者BAE的最佳栓塞材料。因此,本研究旨在比较使用2-氰基丙烯酸正丁酯(NBCA)和聚乙烯醇(PVA)颗粒的BAE在原发性肺癌患者中的安全性和疗效,以确定哪种栓塞材料对咯血患者更好.
方法:这项回顾性研究得到了机构审查委员会的批准,同意被放弃了。止血率,并发症,程序时间,剂量面积产品,回顾性比较了2004年1月至2019年12月期间使用NBCA(n=58)或PVA颗粒(n=64)接受BAE治疗的原发性肺癌(非小细胞[n=111]和小细胞[n=11])患者的无咯血生存率.使用Cox比例风险回归模型分析了复发性咯血的预测因素。
结果:在122例患者中(平均年龄,66±10岁;范围32-86岁;103名男性),NBCA组(81.0%;58例中的47例)实现完全止血的患者多于PVA组(53.1%;64例中的34例)(P=0.002).两组均无重大并发症发生。手术时间(36.4±21.6vs.56.3±27.4min,P<0.001)较短,和剂量面积乘积(58.6±64.0vs.NBCA组的233.5±225.0Gy*cm2,P<0.001)小于PVA组。NBCA组的中位无咯血生存期为173.0天,而PVA组为20.0天(P<0.001)。使用PVA(P<0.001)和凝血功能障碍(P=0.014)是无咯血生存期缩短的独立预测因子。
结论:使用NBCA的BAE显示出明显优于初始止血和更长的无咯血生存期,更短的手术时间,与使用PVA颗粒的BAE相比,辐射剂量降低。PVA使用和凝血功能障碍是反复咯血的独立预测因素。
背景:回顾性注册。
BACKGROUND: Bronchial artery embolisation (BAE) is an effective treatment option to control haemoptysis in primary lung cancer. However, no studies have investigated optimal embolisation material for BAE in lung cancer patients. Thus, this
study aimed to compare the safety and efficacy of BAE performed using n-butyl-2-cyanoacrylate (NBCA) and polyvinyl alcohol (PVA) particles in primary lung cancer patients to determine which embolic material is better for patients with haemoptysis.
METHODS: This retrospective
study was approved by the institutional review board, and consent was waived. The rates of hemostasis, complications, procedure time, dose-area product, and haemoptysis-free survival were retrospectively compared between primary lung cancer (non-small cell [n = 111] and small cell [n = 11]) patients who underwent BAE using NBCA (n = 58) or PVA particles (n = 64) between January 2004 and December 2019. Predictors of recurrent haemoptysis were analysed using the Cox proportional hazard regression model.
RESULTS: Among 122 patients (mean age, 66 ± 10 years; range 32-86 years; 103 men), more patients in the NBCA group (81.0%; 47 of 58) achieved complete hemostasis than did patients in the PVA group (53.1%; 34 of 64) (P = 0.002). No major complications were observed in either group. The procedure time (36.4 ± 21.6 vs. 56.3 ± 27.4 min, P < 0.001) was shorter, and the dose-area product (58.6 ± 64.0 vs. 233.5 ± 225.0 Gy*cm2, P < 0.001) was smaller in the NBCA group than in the PVA group. The median haemoptysis-free survival was 173.0 in the NBCA group compared with 20.0 days in the PVA group (P < 0.001). The PVA use (P < 0.001) and coagulopathy (P = 0.014) were independent predictors of shortened haemoptysis-free survival.
CONCLUSIONS: BAE using NBCA showed significantly superior initial hemostasis with longer haemoptysis-free survival, shorter procedure time, and reduced radiation dose than BAE using PVA particles. The PVA use and coagulopathy were independent predictors of recurrent haemoptysis.
BACKGROUND: Retrospectively registered.