经皮微波消融与胸腔镜肺叶切除术治疗Ⅰ期非小细胞肺癌的疗效

CT-guided percutaneous microwave ablation versus thoracoscopic lobectomy for the treatment of stage Ⅰ NSCLC: analysis of curative effect

目的探究CT引导下经皮微波消融(MWA)与胸腔镜肺叶切除术治疗Ⅰ期非小细胞肺癌(NSCLC)的疗效及预后。方法选取2015年3月至2017年2月139例NSCLC患者作为研究对象。根据治疗方案将139例NSCLC患者分为两组,MWA组(n=65)和胸腔镜组(n=74)。比较两组患者手术疗效、术后并发症发生情况、手术相关指标及生存情况。结果两组患者肿瘤清除率比较,差异无统计学意义(P>0.05)。两组患者治疗期间均未出现死亡病例。两组患者并发症发生率比较,胸腔镜组和MWA组分别为20/74和14/65,差异无统计学意义。胸腔镜组肿瘤100%切除,MWA组肿瘤完全消融,两组差异无统计学意义(P>0.05)。MWA组患者手术时间、术后住院时间及住院费用均低于胸腔镜组,差异有统计学意义(P<0.05)。MWA组患者1、2年总生存率(OS)和无瘤生存率(DFS)与胸腔镜组比较,差异均无统计学意义(P>0.05)。MWA组患者平均总生存时间及平均DFS与胸腔镜组比较,差异无统计学意义(P>0.05)。结论MWA与胸腔镜肺叶切除术治疗Ⅰ期NSCLC疗效相当,且较为安全。MWA治疗Ⅰ期NSCLC的手术时间、术后住院时间及费用均低于胸腔镜肺叶切除术。

Objective To investigate the curative effect and prognosis of CT - guided percutaneous microwave ablation(MWA)and thoracoscopic lobectomy in treating stage I non- small cell lung cancer(NSCLC). Methods A total of 139 patients with NSCLC,who were admitted to authors' hospital during the period from March 2015 to February 2017,were enrolled in this study.According to the therapeutic scheme,the patients were divided into MWA group (n=65) and thoracoscopic group (n=74).The operative efficacy,postoperative complications,operation - related indexes and survival time were compared between the two groups. Results No statistically significant difference in tumor clearance rate existed between the two groups(P>0.05). During the treatment period no death occurred.No statistically significant difference in the incidence of complications existed between the two groups (P>0.05).The time spent for operation,the postoperative hospital stay days and the hospitalization expenses in MWA group were remarkably lower than those in thoracoscopic group,the differences were statistically significant(P<0.05).The one- year and 2- year overall survival(OS) rates and disease-free survival(DFS) rates of MWA group were not obviously different from those of thoracoscopic group,the differences were not statistically significant(P>0.05).The mean total survival time and the mean DFS in patients of MWA group were not significantly different from those in patients of thoracoscopic group (P>0.05).Conclusion In treating stage I NSCLC,MWA has the same curative effect and safety as thoracoscopic lobectomy.However,MWA is superior to thoracoscopic lobectomy in aspects of the time spent for operation,the postoperative hospital stay days and the hospitalization expenses.