射频消融联合化疗治疗周围型中晚期非小细胞肺癌疗效观察

Radiofrequency ablation combined with GP chemotherapy for stage Ⅲ and Ⅳ peripheral non-small cell lung cancer: a clinical observation

目的观察CT引导下射频消融(RFA)联合吉西他滨、顺铂(GP)方案化疗治疗周围型非小细胞肺癌(NSCLC)短期疗效、不良反应和生存率。方法选择32例临床分期为Ⅲ、Ⅳ期周围型NSCLC。随机选16例为观察组:在CT引导下行经皮RFA,术后1周行GP方案化疗,对照组:16例单纯行GP方案化疗。治疗6个月后比较两组的近期疗效、不良反应及每3个月随访1次。结果观察组的近期疗效CR9例(56.3%),PR 4例(25.0)%,有效率为81.3%,对照组CR 1例(6.3%),PR 6例(37.5)%,有效率为43.8%,有效率两组比较差异有统计学意义(P<0.01)。两组不良反应无显著性差异(P>0.05),随访6、9、12、15、18、21和24个月生存率,观察组中位生存期18个月,对照组为15个月,两组中位生存期比较差异无统计学意义(P﹥0.05)。结论 RFA联合GP化疗方案是治疗周围型中晚期NSCLC的安全有效的方法之一。

Objective To investigate the short- term efficacy and side- effect of CT- guided radiofrequency ablation combined with GP chemotherapy for the treatment of stage Ⅲ and Ⅳ peripheral nonsmall cell lung cancer （NSCLC）, and to analyze the survival rate of the patients. Methods A total of 32 cases with peripheral NSCLC of stage 3 or stage 4 were collected for this study. The patients were randomly and equally divided into study group （n = 16） and control group （n = 16）. Patients in study group received CT-guided percutaneous radiofrequency ablation, which was followed by GP chemotherapy one week later. Patients in control group received GP chemotherapy only. Six months after the treatment, the shortterm clinical efficacy and side-effect were evaluated. All the patients were followed up every three months for two years. The results were compared between the two groups. Results The short-term CR and PR of the study group were 56.3% （n = 9） and 25.0% （n = 4） respectively, with a total effect rate of 81.3%. The short-term CR and PR of the control group were 6.3% （n = 1） and 37.5% （n = 6） respectively, with a total effect rate of 43.8%. The difference in the effect rate between the two groups was statistically significant （P 〈 0.01 ）. No significant difference in the occurrence of side-effect existed between the two groups （P 〉 0.05）. The survival rates at 6, 9, 12, 15, 18, 21 and 24 months after the treatment were calculated. The median survival time of the study group and the control group were 18 months and 15 months respectively and the difference between the two groups was not significant （P 〉 0.05）. Conclusion For advanced peripheral non-small cell lung cancer, radiofrequency ablation combined with GP chemotherapy is an effective and safe treatment.