氩氦刀联合支气管动脉灌注治疗中晚期非小细胞性肺癌的疗效评估  

Argon-helium cryoablation combined with bronchial artery infusion for the treatment of advanced non-small cell lung carcinoma

作　　者：胡小波[1] 曹建民[1] 许健[1] 卢光明[1] 陈波[1] 

机构地区：[1]南京军区南京总医院医学影像科,210002

出　　处：《介入放射学杂志》2009年第7期503-506,共4页Journal of Interventional Radiology

摘　　要：目的探讨氩氦刀冷冻消融联合支气管灌注化疗(BAI)治疗中、晚期非小细胞性肺癌的方法、疗效及临床意义。方法将符合入选的20例肺癌患者分为A组(单纯氩氦刀组)和B组(氩氦刀联合BAI组),分别行经皮氩氦刀冷冻治疗及氩氦刀+BAI治疗。治疗后4周开始行CT或DSA随访,通过肿瘤区CT值变化、CT灌注成像、实体瘤治疗评价标准及生存期评价两组的临床疗效。生存期分析采用Breslow方法,分别计算中位生存时间并绘制生存期曲线图。结果本研究80%(16/20)的病例冰球覆盖率>90%。两组间冰球覆盖率差异无统计学意义(P>0.05)。A组CT值变化(16.73±9.43)Hu,B组(15.29±6.98)Hu,差异无统计学意义(P>0.05)。A、B两组治疗前后BF、BV、PS差异有统计学意义(P<0.05),两组间BV差异有统计学(P<0.05)。B组疗效优于A组。20例患者随访期间死亡10例,生存期7～20个月,A组中位生存期为9个月,B组为14个月,两组间差异有统计学意义(P<0.05),B组生存率优于A组。结论氩氦刀冷冻联合BAI治疗直径>3cm的中、晚期非小细胞肺癌是一种安全、有效的方法,疗效优于单纯氩氦刀。CT灌注成像是评估肺癌氩氦刀冷冻治疗疗效的新手段,具有准确、敏感、直观的优点。Objective To investigate the technique, efficacy and clinical significance of argonhelium cryoablation combined with bronchial artery infusion （BAI） for the treatment of advanced non-small cell lung carcinoma. Methods Twenty patients, who met the requirements of this study, were divided into two groups. Patients in group A, were treated with argon-helium cryoablation only, whereas those in group B were treated with argon-helium cryoablation combined with BAI. Four week after the treatment, check-up CT scan or DSA were carried out. CT value of the tumor area both before and after the procedure was measured and compared. The clinical efficacy was evaluated based on the CT value, the parameters of CT perfusion imaging, RECIST criteria and the median survival time. Breslow method was used to figure out the median survival time and to draw the survival curves. Results The coverage of spherical frozen region was over 90% in 80% patients （16/20）. The difference was of no significance in the coverage between two groups （P 〉 0.05）. The CT value of group A and group B was （16.73 ± 9.43） Hu and （15.29 ± 6.98） Hu, respectively, with no significant difference（P〉 0.05）. The blood flow （BF）, blood volume （BV） and PS before the treatment were significantly different from that after the treatment in both group A and group B （P 〈 0.05）. The difference in BV between two groups was statistically significant （P 〈 0.05）. The therapeutic effect of group B was better than that of group A. During the follow-up period, 10 of the 20 patients died. The longest survival time was 20 months and the shortest survival time was 7 months, with the median survival time of 9 months in group A and 14 months in group B, By using Breslow method, the difference between two groups was of statistical significance （P 〈 0.05）. The survival curves showed that the survival rate of group B was higher than that of group A. Conclusion Argon-helium clyoablation combined with BAI is a safe and effect treatme

关 键 词：氩氦刀 CT灌注成像 非小细胞性肺癌 

分 类 号：R734.2[医药卫生—肿瘤]