冷循环微波刀治疗实体肿瘤及猪肝凝固实验的体会

The experience of psychro-circulation microwave to treat solid tumor and experiment of treat pork liver

目的探索微波刀凝固治疗肝癌等实体瘤单刀的较佳治疗技术参数,以便提高疗效。方法使用冷循环微波刀进行离体猪肝治疗实验,借鉴实验结果用70W～75W,10分钟～15分钟治疗人体转移性及原发性肝、肺、肾癌共11例。结果离体猪肝凝固范围(纵径×横经)分别为:70W,单刀,5分钟为3cm×2.3cm、10分钟为3cm×3cm、15分钟为4cm×3.2cm;75W,单刀,15分钟为4cm×3.8cm;70W,双刀,15分钟为4cm×6cm。11例人体肿瘤其近期疗效为:CR2例(18.2%),PR4例(36.4%),SD3例(27.3%),PD2例(18.2%)。结论冷循环微波刀治疗实体瘤局部疗效确切,且微创、副作用少而轻、简便易行,可用于凡可定位并能穿刺到位的多种实体瘤,并可与化疗等疗法有机结合。对于肝肿瘤单刀70W～75W,10分钟～15分钟最大有效凝固范围(纵径×横经)为3-4cm×3-3.2cm,故以70W,15分钟较为适宜。对于最大径<3cm的病灶单刀一次性治疗即可,对于最大径>3cm的病灶以单刀多点叠加治疗可提高疗效且经济而实用。只要布针(刀)合理无盲区必有可靠疗效,若留盲区便有残存,复发或进展即难免。

Objective To explore the technical parameters of microwave coagulation therapy with better therapeutic effect in solid tumor, Methods Experiment of treating pork liver ex vivo by using psychro-circulation microwave coagulation therapy was done, and on the basis of its result we treated 11 patients with tumor using psychro-circulation microwave with 70W-75W and 10- 15minutes. The tumor included liver cancer, lung cancer and renal carcinoma. Results The clotting extent of pork liver ex vivo was described as follows： 70W, single knife, 3cm×2.3cm, 3cm×3cm, 4cm×3.2cm corresponded to 5min, 10min, 15min respectively;75W, single knife, 4cm×3.8cm corresponded to 15min;70W, double knives, 4cm×6cm corresponded to 15min. The recent curative effect of 11 patients was CR 18.2% （n=2）, PR 36.4%（n=4）, SD 27.3%（n=3）, PD 18.2（n=2）. Conclusions Psychro-circulation microwave coagulation treating solid tumor has explicit local effect, little invasive, less adverse reaction and it is convenient. Because of its good quality, most of solid tumor which can be located and punctured could use it. It also can be combined with chemotherapy. For tumor of liver, single knife, 70W-75W, the maximum available extent is 3-4cm×3-3.2cm corresponded to 10-15min, so the suitable parameter is 70W, 15min. Single knife treatment only once is feasible if the tumor＇s maximum diameter is shorter than 3cm;but if the tumor＇s maximum diameter is longer than 3cm, single knife treatment exceeds one is pragmatic and it can elevate the effect .In a word, the reliable effect can be found if therapy is no dead zone and reasonable; if it has residual dead zone, it must be recurred or progressed.