How to standardize the endovascular intervention for lung cancer?

  Currently, the best treatment for lung cancer is radical surgery, and patients with lung cancer are unable to undergo radical surgery for many reasons. At present, the main treatments are systemic intravenous chemotherapy, radiotherapy and targeted therapy. The advantages of endovascular interventions are to increase the concentration of chemotherapeutic drugs in the tumor area by direct infusion of chemotherapeutic drugs through the tumor vessels and to physically cut off the blood oxygen supply to the tumor by embolizing the blood supply vessels of the tumor. The short-term efficacy of endovascular interventions for lung cancer has been recognized, but why this method has not yet been able to become an important part of the comprehensive treatment of non-surgical treatment. There are many reasons, mainly: (1) the multi-body arterial blood supply of lung cancer, which can often involve multiple arteries; (2) some peripheral lung cancers can be supplied by pulmonary circulation; (3) the metastatic mediastinal hilar lymph node blood supply of lung cancer are all multi-body arterial blood supply; (4) interventional physicians mostly ignore the anti-tumor principles of chemical drugs, while neglecting the application of cell cycle-specific anti-cancer drugs.  In my long-term clinical practice, for patients whose lesions do not progress or progress slower than normal tumor multiplication and receive systemic chemotherapy, the treatment effect can be significantly improved after standardized endovascular intervention, and some patients can be completely eliminated after intervention and radical radiotherapy, and some patients can undergo surgical radical surgery when the tumor and intrathoracic metastatic lymph nodes are obviously reduced, and the proportion is about 20%.  Therefore, I believe that the endovascular interventional treatment of lung cancer without surgical indication should be standardized, and the main contents are: (1) the latest protocol of systemic intravenous chemotherapy should be used as the drug standard; (2) systemic intravenous chemotherapy with cell cycle-specific anticancer drugs after interventional chemotherapy should be strictly carried out, and the current protocol is based on platinum (cell cycle non-specific anticancer drugs), and other drugs (cell cycle-specific anticancer drugs) The systemic dosage needs to be supplemented after arterial perfusion; (3) slow drip or push of local intubation is carried out so that the high concentration of chemotherapeutic drug is in continuous contact with the tumor tissue; (4) according to international standards, 4 to 6 segments (4 to 5 weeks) of chemotherapy are used as a cycle, and tumors or metastatic lymph nodes with multivessel blood supply need to be embolized during the first segment of interventional chemotherapy except for one delivery vessel left; (5) at the end of the 4th segment of chemotherapy (5) complete embolization of the tumor vessels at the end of the 4th stage of chemotherapy; (6) active postoperative habitual radiotherapy.