CT引导经皮肺穿刺间质治疗晚期非小细胞肺癌

CT guided percutaneous needle lung interstitial therapy in the treatment of advanced non-small cell lung cancer

目的探讨CT引导经皮肺穿刺瘤内注射化疗药物治疗(间质治疗)晚期非小细胞肺癌(NSCLC)的临床应用及疗效。方法收集晚期NSCLC患者586例,肺内癌灶1026个,在CT引导下经皮细针穿刺至癌灶内并注射抗癌化疗药物,按WHO实体瘤疗效评价标准进行评价,并定期随访。结果穿刺成功率100%,肿瘤内注射药物成功率100%。主要并发症有发热(215/586,36.69%)、局部疼痛(305/586,52.05%)、气胸(38/586,6.48%)、瘤周出血(26/586,4.44%)、针道出血(37/586,6.31%)、痰中带血(71/586,12.12%)等。治疗有效率为76.28%(447/586),疾病控制率为90.44%(530/586)。随访6个月生存率为81.74%(479/586),1、2、3年生存率分别为63.48%(372/586)、35.67%(209/586)、19.28%(113/586)。结论 CT引导经皮肺穿刺间质治疗晚期NSCLC操作简便,并发症少,患者耐受性好、近期疗效显著,值得临床推广应用。

Objective To explore the clinical application and efficacy of CT guided percutaneous pulmonary puncture in- terstitial therapy in advanced non-small ceil lung cancer （NSCLC）. Methods Totally 586 NSCLC patients with 1026 pul- monary lesions were enrolled. CT guided percutaneous fine needle aspiration was applied, and anticancer chemotherapy drugs were injected. The efficacy was evaluated according to WHO solid tumor response evaluation criterion, and the pa- tients were regular followed-up. Results Successful rate of puncture and intratumoral injection of drug were both 100%. The main complications included fever （215/586, 36.69%）, local pain of injection （305/586, 52.05 %）, pneumothorax （38/586, 6.48%）, peritumoral （26/586, 4.44%）, needle tract bleeding （37/586, 6.31%）and blood in sputum （71/586, 12.12%）. Response rate was 76.28% （447/586）, disease control rate was 90.44% （530/586）. Six months＇ survival rate was 81.74% （479/586）, 1, 2, 3-year survival rates was 63.48%（372/586）, 35.67% （209/586） and 19.28% （113/ 586）, respectively. Conclusion CT guided percutaneous needle lung interstitial in treatment of advanced NSCLC has the advantages of simple operation, less complications, significant short-term effect, and the patient tolerance is good. It is worthy of clinical application.