中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

食管癌局部注射紫杉醇-纳米碳后淋巴趋向性及药物浓度的前瞻性非随机对照研究

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目的 比较化疗药物通过紫杉醇淋巴化疗(LCP)或单药局部注射化疗(PTX)在淋巴结和血液中的分布情况,研究纳米碳示踪显影对于淋巴结清扫的意义。 方法 纳入 2015 年 5 月至 2016 年 2 月华西医院胸外科 80 例食管癌患者,将他们分为两组:LCP 组,男 35 例、女 5 例,年龄(60.63±8.78)岁;PTX 组,男 30 例、女 10 例,年龄(62.13±7.89)岁。观察术后并发症发生率,对比淋巴结清扫总数、胸腹腔淋巴结清扫数目、药物在血液及淋巴结中的浓度。 结果 LCP 组与 PTX 组术后并发症发生率均未增加。LCP 组各组淋巴结的浓度均高于 PTX 组。淋巴结清扫数目比较:LCP 组收集到淋巴结共 771 枚,平均每例(19.27±7.77)枚;PTX 组共收集到淋巴结 658 枚,平均每例(16.45±7.12)枚,差异无统计学意义(P>0.05)。 结论 纳米碳载体吸附紫杉醇可以有效提高化疗药物在局部注射后淋巴结中的药物浓度。纳米碳对于提高食管癌淋巴结清扫可能没有意义。

Objective To compare the distribution of drug concentration in lymph nodes and blood between lymphatic chemotherapy and single drug chemotherapy and to study if nano carbon can enhance the number of lymph node dissection. Methods From June 2015 to February 2016, 80 patients with esophageal cancer in the Department of Thoracic Surgery, West China Hospital were enrolled and they were divided into two groups: a lymphatic chemotherapy with paclitaxel (LCP) group and a paclitaxel alone (PTX) group. There were 35 males and 5 females with an average age of 60.63±8.78 years in the LCP group, and 30 males and 10 females with an average age of 62.13±7.89 years in the the PTX group. We observed the incidence rate of complications after operation, the number of lymph node dissection and the rate of lymph node metastasis. The drug concentration in the blood and lymph nodes between the two groups was compared. Results The postoperative morbidity did not increase in the both groups, which did not have adverse drug reactions such as bone marrow suppression, gastrointestinal reaction and so on. The concentration of chemotherapy drug in lymph nodes in the LCP group was higher than that in the PTX group. The LCP group collected 771 lymph nodes, and the average number was 19.27±7.77 for each patient; the PTX group collected 658 lymph nodes, and the average number was 16.45±7.12 for each patient; but the difference between two groups was not statistically significant (P>0.05). Conclusion Nano carbon carriers can effectively improve the drug concentration in lymph nodes after the local injection of chemotherapy drugs. The use of nano carbon tracer in the operation to improve lymph node dissection may not have significance.

关键词: 食管癌; 淋巴化疗; 紫杉醇; 药物浓度

Key words: Esophageal cancer; lymphatic chemotherapy; paclitaxel; drug concentration

引用本文: 蔡杰, 刘鑫, 王文凭, 胡伟鹏, 杨玉赏, 张利, 陈龙奇. 食管癌局部注射紫杉醇-纳米碳后淋巴趋向性及药物浓度的前瞻性非随机对照研究. 中国胸心血管外科临床杂志, 2018, 25(11): 929-934. doi: 10.7507/1007-4848.201712044 复制

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