CT引导靶向经皮冷冻在肺癌治疗中的作用分析

The application of computed tomography guided percutaneous cryoablation in the treatment of lung cancer

目的分析评估CT引导的靶向经皮冷冻在肺癌治疗中的并发症及疗效。方法采用CT引导靶向经皮冷冻治疗816例肺癌患者,观察近期疗效、1年和2年生存率、治疗前后Karnofsky Performance Status(KPS)评分及冷冻术后并发症。结果冷冻治疗后好转率为81.9%,有效率为100%。1年和2年生存率分别为70.0%和54%,中位生存期24个月。冷冻后KPS评分较冷冻前显著提高(P<0.01)。其中4例死于肺部感染2例、支气管胸膜瘘及血气胸各1例,其他患者并发症程度较轻,对症处理后均恢复良好。结论 CT引导靶向经皮冷冻治疗肺癌具有微创、适形、高效的特点,并发症相对较少,为肺癌提供了有效的治疗选择。

Objective To investigate the safety and efficacy of CT guided percutaneous cryoablation in the treatment of lung cancer.Methods 816 patients with lung cancer were treated with CT guided percutaneous cryoablation,and curative effect,1-year and 2-year survival rate,Karnofsky Performance Status（KPS）and cryoablation-related complications were detected.Results According to Response Evaluation Criteria in Solid Tumor（RECIST）,improvement rate was 81.9% and the total efficacy rate was 100%.1-year and 2-year survival rate was 70.0% and 54%,respectively.Median survival was 24 months.KPS increased significantly from 86.2±7.8 to 79.9±9.3（P0.01）.Cryoablation-related complications were comparatively mild,all of which were controlled well after symptomatic treatment except for 4 deaths from pulmonary infection（2 cases）,bronchopleural fistula（1 case）and hemopneumothorax（1 case）,respectively.Conclusions CT guided percutaneous cryoablation was a safe method for palliation of lung cancer,which also showed advantage in minimal invasion,formal adaption,accurate and complete ablation,and could be considered as an alternative method for the treatment of lung cancer.