Objective To investigate the effectiveness and safety of drug-eluting beads bronchial arterial chemoembolization(DEB-BACE)versus BACE for the treatment of stage Ⅲ-Ⅳ lung squamous cell carcinoma.Methods A total of 104 patients with stage Ⅲ-Ⅳ lung squamous cell carcinoma,who were admitted to the Lishui Municipal Central Hospital of China between January 2013 and August 2021,were enrolled in this study.According to the therapeutic scheme,the patients were divided into DEB-BACE group(n=41)and BACE group(n=63).For patients of DEB-BACE group,Cisplatin at 75 mg/m2 dose and gemcitabine at 1 000 mg/m2 dose(400 mg was used as loaded-drug dose)were injected through a microcatheter,which was followed by embolization with CalliSpheres microspheres loaded with 400 mg of gemcitabine.For patients of BACE group,Cisplatin at 75 mg/m2 and gemcitabatin at 1 000 mg/m2 were injected through a microcatheter,which was followed by arterial embolization with blank microspheres.Three weeks after DEB-BACE or BACE,the patients of both groups were started on intravenous chemotherapy.The primary study endpoint was overall survival(OS).The secondary study endpoints included progression-free survival(PFS),objective response rate(ORR),disease control rate(DCR),adverse reactions,and the remission rate of dyspnea.Results Of the 104 patients,63 received BACE sequential intravenous chemotherapy and 41 received DEB-BACE sequential intravenous chemotherapy.The median OS in DEB-BACE group was 23.0 moths,which was obviously longer than 12.0 months in BACE group(P=0.009).Multivariate Cox regression analysis showed that DEB-BACE treatment was an independent risk factor for OS(HR=0.59,95％ CI:0.38-0.91,Log-rank test P=0.018).Meanwhile,the remission rate of dyspnea in DEB-BACE group was significantly higher than that in BACE group(57.1％ vs 30.6％,P＜0.043).Conclusion Compared with BACE sequential intravenous chemotherapy,DEB-BACE sequential intravenous chemotherapy can significantly prolong the survival time of patients with stage Ⅲ-Ⅳ lung squamous cell carcinoma and significantly improve the symptoms of dyspnea,which has important applications in the treatment of patients with advanced lung squamous cell carcinoma.

Objective To investigate the clinical value of sarcopenia in predicting the efficacy of bronchial artery chemoembolization(BACE)in patients with lung cancer.Methods The clinical data of 160 patients with lung cancer,who received BACE treatment at the Lishui Municipal Central Hospital of China from December 2012 to August 2021,were retrospectively analyzed.Using CT images to measure and calculate the skeletal muscle index(SMI)at the 4th thoracic vertebra(T4)level,patients with T4-SMI below the gender specific quartile were classified in sarcopenia group(n=40),and patients with T4-SMI above the threshold were classified in non-sarcopenia group(n=120).Kaplan-Meier method was used to compare the differences in progression-free survival(PFS)and overall survival(OS)between the two groups after BACE treatment,and Cox regression analysis was used to determine the risk factors affecting prognosis.Results In the non-sarcopenia group and the sarcopenia group,the median PFS was 5.6 months and 3.0 months respectively(x2=5.141,P=0.023),and the postoperative 14-month PFS rates were 16.7％and 5.0％respectively.There was no statistically significant difference in OS between the two groups(P＞0.05).Cox multivariate analysis showed that sarcopenia(HR=1.557,95％CI=1.083-2.238,P=0.017)was an independent risk factor for postoperative PFS after BACE.Conclusion Sarcopenia is an independent risk factor affecting the efficacy of BACE in patients with lung cancer,and sarcopenia can be used as a predictive indicator for the postoperative efficacy of BACE.

Objective To evaluate the long-term efficacy of transjugular intrahepatic portosystemic shunt(TIPS)with bare stents and Fluency covered stents in the treatment of portal hypertension,and to discuss its clinical value.Methods The clinical data of 29 patients with intractable ascites or esophagogastric fundus varices rupture and hemorrhage caused by cirrhotic portal hypertension,who received TIPS with bare stents and covered stents at the First Affiliated Hospital of Xinjiang Medical University of China(25 patients)and the Lishui Municipal Central Hospital of China(4 patients)between August 2012 and December 2017,were retrospectively analyzed.The patients were regularly followed up to check the survival status.The postoperative cumulative shunt patency rate and cumulative survival rate of the patients were analyzed by Kaplan-Meier method.Results The technical success rate of TIPS was 100％.The mean portal vein pressure was decreased from preoperative(40.21±3.24)cmH2O to postoperative(24.55±3.55)cmH2O(P＜0.05).The patients were followed up for 5.1-10.5 years.The postoperative 1-,3-,5-,7-year primary cumulative patency rates of the shunt were 89.7％,75.9％,75.9％ and 52.5％,respectively.The postoperative 5-,7-,9-and 10-year cumulative survival rates were 100％,66.9％,66.9％ and 33.4％,respectively.The incidence of hepatic encephalopathy was 13.8％(4/29).Conclusion Using bare stents combined with Fluency covered stents for TIPS is clinically safe and effective in the treatment of portal hypertension.This technique carries higher long-term shunt patency rate and low incidence of hepatic encephalopathy.Therefore,it can be used as a substitute for Viatorr stent when necessary.(J Intervent Radiol,2024,33:295-299)

At present,bronchial arterial chemoembolization(BACE)is a well-established,local minimally-invasive palliative treatment technique for mid-to-advanced primary lung cancer.However,its technical details are still controversial,and it is difficult to standardize each technical detail.Through reviewing the literature,this paper provides a detailed review of BACE,focusing on the source of lung cancer blood supply,embolization materials,particle size of embolization materials,number of treatments,embolization endpoints,selection of anti-tumor drugs,complications,therapeutic effect,etc.(J Intervent Radiol,2024,33:330-334)

Objective To compare the curative effect and safety of drug-eluting beads bronchial artery chemoembolization(DEB-BACE)with those of simple intravenous chemotherapy in treating elderly patients with intermediate to advanced lung cancer.Methods A total of 213 patients aged＞65 years with intermediate to advanced lung cancer,who were admitted to the Lishui Municipal Central Hospital of China between January 2018 and January 2022,were enrolled in this study.According to the therapeutic scheme,the patients were divided into chemotherapy group(n=107)and DEB-BACE group(n=106).After propensity score matching,chemotherapy group and the DEB-BACE group had 42 patients each.The short-term efficacy and the incidence of adverse reactions were compared between the two groups.Survival curve and Log-rank test were used to compare the survival between the two groups.Cox regression analysis was used to analyze the factors influencing the prognostic survival.Results The postoperative one-,3-,and 6-month disease control rate and objective remission rate in DEB-BACE group were better than those in the chemotherapy group.Before propensity score matching,the median progression-free survival(mPFS)time in DEB-BACE group was 7.0 months,which in the chemotherapy group was 6.0 months(P＜0.001).After propensity score matching,the mPFS in DEB-BACE group was 7.0 months,which in the chemotherapy group was 5.0 months(P=0.001).Before propensity score matching,the median overall survival(mOS)time in DEB-BACE group was 23.0 months,which in the chemotherapy group was 20.0 months(P＜0.001).After propensity score matching,the mOS in DEB-BACE group was 24.0 months,which in the chemotherapy group was 18.0 months(P=0.001).Multivariate Cox regression analysis revealed that therapeutic scheme,tumor size,and TNM stage were the influencing factors for OS.In terms of the adverse reactions,the incidences of both the pre-matched and post-matched myelosuppression in DEB-BACE group were lower than those in the chemotherapy group(P＜0.05).Conclusion For the treatment of intermediate to advanced lung cancer in elderly patients,DEB-BACE is superior to simple intravenous chemotherapy in curative efficacy and safety.