51例肺癌经皮射频消融治疗疗效及预后因素分析

Efficacy and Safety of Percutaneous Radiofrequency Ablation for Patients with Lung Cancer

[目的]评价应用经皮射频消融治疗肺癌的疗效和安全性,并分析影响其预后的因素。[方法]将随访资料完整的51例肺癌患者纳入分析,应用经皮射频消融进行治疗,评价近期及远期疗效和治疗并发症。应用Kaplan-Meier法和多因素Cox模型分析全组患者的生存预后情况。[结果]全组患者获CR4例(7.8%),PR 31例(60.8%),SD 11例(21.6%),PD 5例(9.8%)。疾病控制率为90.2%。随访0.5~3年,随访率为92.7%。0.5、1、2、3年的生存率分别为53%、32%、16%和4%,中位总生存时间(OS)为19.2个月。21例出现并发症,术中出现气胸1例,咯血3例。其他术后并发症包括胸部疼痛2例、术后发热15例。Cox多因素分析显示,肿瘤直径、临床分期、有无结合化疗和KPS评分是影响预后的独立因素。[结论]经皮射频消融治疗肺癌近期和远期疗效均较好,并发症可耐受;肿瘤直径、KPS评分、临床分期、有无结合化疗可能是影响经皮射频消融治疗肺癌预后的因素。

[Objective] To evaluate the efficacy and safety of percutaneous radiofrequency ablation in treatment of lung cancer. [Methods] Fifty-one patients with lung cancer were treated with percutaneous radiofrequency ablation,the short-,long-term curative effect and complications were evaluated.Kaplan-Meier method and multivariate Cox model were used to analyze the prognosis of patients. [Results] There were 4 cases of CR（7.8%）,31 cases of PR（60.8%）,11 cases of SD（21.6%）and 5 cases of PD（9.8%）with a disease control rate of 90.2%. Patients were followed up for 0.5 ~3 years with a followed rate of 92.7%. The 0.5-,1-,2-and 3-year survival rates were53%,32%,16% and 4%,respectively,with a median overall survival time of 19.2 months. Complications occurred in 21 patients,including pneumothorax（1 case）hemoptysis（3 cases）,chest pain（2 cases）and postoperative fever（15 cases）. Cox multivariate analysis showed that tumor diameter,clinical stage,with or without chemotherapy and KPS score were independent prognostic factors.[Conclusion] Percutaneous radiofrequency ablation is effective in treatment of lung cancer and the complications are tolerated. Tumor diameter,KPS score,clinical stage,and combinated chemotherapy are factors affecting the prognosis of patients.