氩氦刀冷冻消融联合放、化疗治疗NSCLC疗效观察

Clinical Observation on Therapeutic Effect of Combining Percutaneous Targeted Argon-helium Cryoablation in Treating NSCLC by Radiotherapy and Chemotherapy

目的探讨经皮肺穿刺氩氦刀靶向冷冻消融术联合放、化疗治疗中晚期非小细胞肺癌(NSCLC)的临床疗效。方法在CT引导下,根据肿瘤大小、方位选用不同直径及数目的氩氦刀靶向对NSCLC患者进行治疗,并与氩氦刀+化疗+放疗组进行对比观察。结果经氩氦刀冷冻消融治疗后,CT值较术前下降超过30 Hu 23例,占67.65%。术后1周、1、3、6、12个月经复查CT示,术后1周肿瘤体积增大34例,占100%,两组患者1、3、6、12个月有效率分别为70%、57.1%;80%、71.4%;85%、78.5%;85%、64.3%。两组病人经不同方案治疗后KPS评分提高20分者A、B两组分别为20%、64.28%。结论经皮穿刺氩氦刀靶向冷冻消融联合放、化疗比单纯氩氦刀治疗中晚期非小细胞肺癌临床疗效好,但副作用明显增加。

Objective To explore the therapeutic effect of combining percutaneous targeted argon-helium cryoablation by radiotherapy and chemotherapy in treating nonsmall-cell lung cancer（NSCLC）. Methods Guided by CT, different argon-helium knives in various sizes were chosen to treat 34 NSCLC cases who had no chance of undergoing surgical operation, and cryoablation was done at the same time. Then those patients are randomly divided into group A with the combined treatment of percutaneous targeted argon-helium cryoablation and radiotherapy and chemotherapy （20 cases）, group B with percutaneous targeted argonhelium cryoablation only（ 14 cases）, thus comparing the different effects in those groups. Results After percutaneous targeted argon-helium cryoablation, about 67.65% of the patients＇ CT value decreased more than 30Hu（23/34）. One week after treatment, about 100% of the patients found their gross tumor volume increased with CT recheck, the effective rates one month , three months, six months, twelve months later were 70% ,57. 1% ;80% ,71.4% ;85% ,78.5% ;85% ,64.3% respectively. In terms of a 20 score increase in KPS evaluation, group A and group B accounted for 20% and 64. 28% separately. Conclusion Combining percutaneous targeted argon-helium cryoablation with radiotherapy and chemotherapy is an effective way to treat intermediate and advanced NSCLC patients, but the side effects increase evidently as well.