目的

探讨载药微球支气管动脉化疗栓塞术（drug-eluting bead bronchial artery chemoembolization，D-BACE）治疗罕见非小细胞肺癌（non-small cell lung cancer， NSCLC）的临床疗效和安全性。

方法

回顾性分析2019年1月至2023年12月广东省人民医院微创介入科收治的8例接受D-BACE治疗的罕见NSCLC患者的临床资料。纳入患者均经病理确诊，其中肺腺样囊性癌3例、淋巴上皮瘤样癌2例、SMACAR4缺失型肺癌2例、肺肉瘤样癌1例。观察D-BACE的临床疗效和安全性。

结果

患者平均年龄（51.0±3.4）岁，其中男性5例，女性3例。联合外科手术切除1例，联合化疗免疫4例，联合安罗替尼治疗3例；首次D-BACE治疗后客观反应率为25%（2/8），疾病控制率87.5%（7/8）。中位随访时间为18个月，中位无进展生存期为6个月，中位总生存期未达到。不良反应主要有局部轻微疼痛2例（25%），恶心呕吐2例（25%），发热1例（12.5%），胸部麻木1例（12.5%），所有不良反应均为轻微不良反应，可自行缓解或经药物对症治疗后缓解，未观察到严重并发症。

结论

D-BACE联合系统治疗用于罕见非小细胞肺癌的治疗是安全、可行的，D-BACE作为一种可选择的局部治疗手段的临床价值有待于进一步探索。

Objective

To explore the clinical efficacy and safety of drug-eluting bead bronchial artery chemoembolization （D-BACE） in the treatment of rare non-small cell lung cancer （NSCLC）.

Methods

The clinical data of 8 patients with pathologically confirmed rare NSCLC who underwent D-BACE treatment were analyzed. The types of cancer included adenoid cystic carcinoma （3 cases），lymphoepithelioma-like carcinoma （2 cases）， SMACAR4-deficient lung cancer （2 cases）， and pulmonary sarcomatoid carcinoma （one case）. The clinical efficacy and safety of D-BACE were evaluated by observing objective response rate， disease control rate， progression-free survival （PFS）， and overall survival （OS）.Adverse reactions during the treatment process were also recorded and assessed.

Results

The average age of the patients was （51.0±3.4） years， with 5 males and 3 females. Among them， 1 patient underwent surgical resection in combination with D-BACE， 4 patients received chemotherapy and immunotherapy in combination with D-BACE， and 3 patients were treated with anlotinib in combination with D-BACE. After the first D-BACE treatment， the objective response rate was 25% （2/8）， and the disease control rate was 87.5% （7/8）. The median follow-up time was 18 months， with a median PFS of 6 months. The median OS has not yet been reached. Common adverse reactions included mild local pain （2 cases， 25%）， nausea and vomiting （2 cases， 25%）， fever （1 case， 12.5%）， and chest numbness （1 case， 12.5%）. All adverse reactions were mild and self-limited or relieved after symptomatic medication treatment. No serious complications were observed.

Conclusion

The combination of D-BACE and systemic treatment for rare non-small cell lung cancer is safe and feasible. However， further studies are needed to evaluate its long-term efficacy as the median overall survival has not yet been reached. The clinical value of D-BACE as a selective local treatment option warrants further exploration.