MSCT引导下经皮穿刺微波治疗周围型非小细胞肺癌的临床疗效观察

MSCT guided percutaneous microwave coagulation therapy for peripheral non-small cell lung cancer

目的:探讨MSCT引导下经皮经肺微波热凝固(MCT)治疗周围型非小细胞肺癌的临床疗效,确定其临床应用价值。方法:在MSCT引导下,经皮经肺穿刺MCT治疗周围型非小细胞肺癌32例(共34个病灶)。微波频率2 500MHz,功率60～80W,每个固化点加热10～15min。根据肿瘤的直径及形状进行单点固化或者多点多次固化。结果:肿瘤MCT治疗后即刻,MSCT表现为病灶密度减低或出现气化灶。治疗后2个月复查MSCT显示病灶消失者(CR)4例,病灶缩小>50%者(PR)19例,有效率(CR+PR)为67.6%。随访3～40个月,1年、2年及3年生存率分别为68.8%(22/32),46.9%(15/32),28.1%(9/32)。相关并发症为气胸4例,胸腔积液1例,肺部感染1例。结论:MSCT引导经皮穿刺MCT治疗周围型肺癌是有效、微创和安全的新方法。

Objective： To evaluate the clinical effect and side-effects of percutaneous microwave coagulation therapy for periph-eral non-small cell lung cancer. Methods： MSCT-guided percutaneous microwave coagulation therapy was performed using a nee dle mono-pole microwave antenna to treat 32 patients（34 nodules）of peripheral non-small cell lung cancer. The microwave ener-gy was set at 2500 MHz and at 60-80 watt for 10-15min. The treatment was conducted by using single or multiple simultaneous-ly-powered antennas according to the size and shape of the tumor. Results：After coagulation, lower density or gasification in the coagulated area was observed in MSCT image. CR was observed in 4 patients and PR（diminution of over 50 % ）was observed in 18 patients. The overall response rate（CR＋PR） was 64.7% （22/34）. The 1-,2-, 3-years survival rate was 68.8% （22/32）, 46.9 %（15/32）, 28.1% （9/32）, respectively. Related complication was observed including pneumothorax in 7 cases, pleural effu-sion in lcase and pulmonary infection in one case. Conclusion： MSCT guided percutaneous microwave coagulation therapy is an effective,minimally invasive and safe treatment for peripheral lung cancer.