[Clinical study of ischemic preconditioning on isolated lung perfusion with chemotherapeutic agents in the treatment of unresectable lung cancer].
OBJECTIVE
To determine the effect of ischemic preconditioning on isolated lung perfusion (ILP) with chemotherapeutic agents in the treatment of unresectable lung cancer.


METHODS
Eight patients with unresectable cancer or metastatic sarcomas in lungs underwent isolated single lung perfusion with doxorubicin. Eight patients were randomly divided into two groups: control group (Group C) and ischemic preconditioning group(Group IP). Group C was only performed isolated lung perfusion with doxorubicin; Group IP was performed isolated lung perfusion with doxorubicin after ischemic preconditioning (in ischemic preconditioning procedure, right or left pulmonary artery was clamped for 10 minutes, then released for 15 minutes).


RESULTS
The mean pulmonary artery pressure (MpaP) after ILP in Group IP was much lower than that in Group C (P < 0.05). The PaO2 after ILP in Group IP was much higher than that in Group C(P < 0.01). The lung histologic examination after ILP showed that pulmonary edema, inflammatory cell infiltration, mild focal hemorrhage and alveolar disruption in Group C were significantly serious than those in Group IP, but there was no hospital death in Group C or in Group IP. The complications included hypovolemia shock and acute lung injury. Following up 2 months to 10 months, no death was observed, and the tumours diminished in various degrees or disappeared in the two groups.


CONCLUSIONS
Isolated lung perfusion with chemotherapy can be done safely and effectively in patients with unresectable lung malignancies and metastatic sarcoma in the lung, and ILP can cause lung injury, but lung ischemic preconditioning can reduce the lung injury after isolated lung perfusion.
Zhang
C F
CF
Department of Cardiothoracic Surgery, Xiangya Hospital, Central Medical University, Changsha 410008.
Chen
S X
SX
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D004317:Doxorubicin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D019194:Ischemic Preconditioning; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012509:Sarcoma / Q000188:drug therapy*
D000970:Antineoplastic Agents; D004317:Doxorubicin