氩氦刀冷冻消融挽救治疗胃癌肝转移患者

Argon-helium knife cryoablation for the treatment of liver metastases from gastric cancer

目的探讨氩氦刀冷冻消融挽救治疗胃癌肝转移患者的疗效及安全性。方法回顾分析接受氩氦刀冷冻消融的24例胃癌肝转移患者的临床资料,其中33个可评价病灶。所有患者行CT引导下经皮穿刺肝转移瘤冷冻治疗,研究内容包括术后3个月、6个月及1年的肿瘤局部控制率,总生存率,疾病无进展生存时间,病灶的复发情况,术前术后患者生活质量变化情况及并发症。结果患者中位随访时间为14(6~48)个月。冷冻消融术后患者生活质量明显提高,术后3个月、6个月及1年的病灶局部控制率分别为91.7%,73.9%,52.6%。经过冷冻消融治疗后,中位疾病无进展生存期为8(1~16)个月,患者中位生存时间为16个月,1年及2年生存率为75.0%及37.5%,未见严重并发症。结论氩氦刀冷冻消融治疗胃癌肝转移,安全有效,近期疗效确切,可提高患者生活质量。

Objective To evaluate the curative effect and safety of percutaneous argon-helium knife cryoablation in treating patients with liver metastases from gastric cancer. Methods The clinical data of 24 patients with liver metastases from gastric cancer, who had received percutaneous argon- helium knife cryoablation therapy, were retrospectively analyzed. A total of 33 metastatic lesions could be used for evaluation. CT-guided percutaneous argon-helium knife cryoablation of liver metastases was carried out in all patients. The 3-month, 6-montil and 12-month local control rate, overall survival （OS） rate, progression -free survival （PFS）, incidence of recurrence, preoperative and postoperative quality of life, and complications were documented. Results The median follow-up time was 14 months （6-48 months）. After cryoablatiou therapy, the quality of life was improved significantly. The 3-month, 6-month and 12-month local control rates were 91.7%, 73.9% and 52.6% respectively. After cryoablation therapy, the median PFS was 8 months （1-16 months）, the median survival time was 16 months, and the one-year and 2-year survival rates were 75.0% and 37.5% respectively. No severe complications occurred. Conclusion For the treatment of liver metastases from gastric cancer, percutaneous argon- helium knife cryoablation is safe and effective with reliable short- term curative effect, the patient＇s quality of life can be well improved. （J Intervent Radiol, 2018, 27： 40-44）