冷冻消融挽救治疗放化疗失败的Ⅲ期非小细胞肺癌初步观察

Clinical study of cryoablation in the salvage treatment of stage Ⅲ non-small cell lung cancer

目的评价冷冻消融（CA）对放化疗失败后非小细胞肺癌（NSCLC）进行挽救性治疗的有效性和安全性。方法2005年2月至2008年9月天津医科大学附属肿瘤医院介入治疗科12例接受放化疗后进展或复发的Ⅲ期NSCLC患者接受挽救性CA治疗。研究的终点目标是总反应率（RR）、临床受益率（CBR）、1年生存率、生活质量（QOL）以及安全性等。结果CA治疗组12例可评价疗效的患者中，术后12个月，总RR率为6／12例，CBR7／12例，1年生存率为10／12例，不良反应主要包括术后术区不适感及轻度咯血，无严重不良事件发生。生活质量评分结果证实患者可获得较好的生活质量。结论CA挽救性治疗放化疗失败的NSCLC可获得较高的RR及1年生存率且安全性较好，是Ⅲ期NSCLC挽救性治疗的新选择，具有较好的临床应用前景。

Objective To evaluate the efficacy and safety of argon-helium cryoablation as a salvage therapy for the failure cases of non-small cell lung cancer （NSCLC） after radiochemotherapy. Methods A total of 12 NSCLC patients （ stage Ⅲ） with a diagnosis of recurrence after radiochemotherapy received cryoablation. The endpoint objectives were overall response rate （RR）, clinical benefit rate （CBR）, 1-year survival rate, quality of life （QOL） and safety profile. Results Among them, the overall response rate was 6/12 cases and the clinical benefit rate 7/12 cases at 12 months post-cryoablation. The 1-year survival rate was 10/12 cases. No significant complications or adverse reactions occurred during the process of cryoablation. As shown by the QOL score, the quality of life was satisfactory. Conclusion As a salvage treatment for the recurrence NSCLC cases after radiochemotherapy, cryoablation may achieve a high response rate, a favorable 1-year survival rate and a high safety profile. It has excellent prospects for clinical applications.