氩氦刀冷冻治疗早期结节型非小细胞肺癌可行性观察

Cryoablation of T1N0M0 non–small cell lung cancer in medically inoperable patients

目的探讨氩氦刀冷冻消融治疗不适合手术的早期结节型非小细胞肺癌的临床疗效和安全性。方法回顾性分析2019年10月—2021年3月于本中心接受氩氦刀冷冻消融治疗的38例T1N0M0非小细胞肺癌患者的临床资料。观察分析氩氦刀治疗的技术成功率,局部控制率,1年及2年生存率及并发症等。结果38例患者术中冰球覆盖均满意,获得完全消融,技术成功率100%。中位随访时间14.9(6.3~25.5)个月,随访期内有11例达病灶完全缓解,有4例局部进展,局部控制率89.5%。1年无进展生存率96.7%,2年无进展生存为87.9%;根据病灶大小,对比T1a-b及T1c的无进展生存,结果发现两亚组间差异无统计学意义(P=0.35)。随访期内未出现死亡病例。术中并发症主要为气胸、肺泡出血,术后并发症主要为咳嗽加重、气胸,未出现严重并发症。结论氩氦刀冷冻消融术是不适合外科手术切除的早期结节型肺癌可行且安全有效的方法。

Objective To evaluate the clinical efficacy and complications of cryoablation for T1N0M0 non-small cell lung cancer(NSCLC).Methods The clinical data of 38 patients with T1N0M0 NSCLC who underwent CT guided percutaneous cryoablation between October 2019 and March 2021 was retrospectively analyzed.The study outcomes included technical success,the local control rate,1-year and 2-year progression free survival rate and complications.Results All patients obtained satisfactory iceball coverage and the rate of technical success was 100%.The median follow-up was 14.9(6.3-25.5)months.During the follow-up,11 patients achieved completed remission,four cases suffered local progression,the local control rate was 89.5%.1-year progression free survival rate was 96.7%,and 2-year progression free survival rate was 87.9%.The comparison of progression free survival between the T1a-b and T1c was conducted,but no significant difference was detected(P=0.35).There was no death happened during follow-up.The intraoperative complications were pneumothorax and alveolar hemorrhage,and the postoperative complications were exacerbation of cough and pneumothorax.All complications were mild and controllable.Conclusion CT-guided percutaneous cryoablation is clinically feasible,effective and safe therapeutic method for inoperable T1N0M0 NSCLC.