Studies on Lung Cancer Angiogenesis-Application of Interventional Therapy (A Report of 56 Cases)

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OBJECTIVE To investigate the significance of angiogenesis of lung cancer,in order to provide a scientific basis for interventional therapy.METHODS Double.phase enhancement-scanning spiral CT and DSA were performed in 56 pathologically confirmed lung cancer cases,in order to evaluate angiogenesis of the tumors.The patients included 36 males and 20 females.with ages ranging from 33 to 76 years (average of 53).Assessments and indexes for SCT and DSA examinations were as follows:a) Peak value (PV)of the cancerous focus was the difference between the maximum CT value after enhancement and the CT value of a plain scan;b)The abnormally distorted and expanded new vessels of the cancerous focus which could be macroscopically discriminated;c) DSA staining of the focus of cancer was sparse,grid-like and dense.Chemotherapy and embolotherapy via the bronchial artery (interventional therapy) were conducted.Radiotherapy was added for some of the solid tumors with a diameter exceeding 4 cm.RESULTS a) There were 25 cases with a central-type lesion,among which 4 were small cell lung cancers (SCLC) and 21 non-small cell lung cancers (NSCLC).The cases with a peripheral location accounted for 31 of the total.with a maximum diameter of 1.5 to 13.5 cm and a median of 4.2 cm,including 5 small cell lung cancers and 26 NSCLC cases.b) The reinforced PVs of the cancerous foci were as follows:The PV ranged from 45 to 70 Hu in 34 cases.25 to 45 Hu in 19,and 10 to 25 Hu in 3.Sparse DSA staining occurred in 3 cases,there was uneven grid-like staining in 22 and dense staining in 31:c) The interventional therapy via the bronchial artery was conducted twice in 5 cases with the SCLC.and three times in 4 SCLC cases.For 3 of the latter cases,a dose of 5,000 to 7,000 cGy radiation therapy was added during the interventional treatment.Complete remissions (CR) were seen in 88.9% of the cases (8/9) and partial remission (PR) in 11.1%(1/9).Interventional therapy was conducted twice in 8 cases with NSCLC and three times in 30 with NSCLC and four times in 9 cases.Among the total cases,13 received radiotherapy during interventional therapy,with a radiation dose of 5,000-7,000 cGy;The CR rate was 78.7%(37/47),PR was 14.9%(7/47) and the rate of non-remission was 6.4% (3/47).CONCLUSION Using imaging technology,analysis of angiogenesis of lung cancers was employed to accurately detect and quantify angiogenesis.This analysis was combined for interventional therapy.using embolizing agents and large doses of the anti-tumor drugs and angiogenesis inhibitors.The agents were selectively delivered into the tumor vessels to eliminate the primary lumor,in order to depress distant metastases and thus enhance the curative effect of the therapy.
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