射频消融术治疗肺部肿瘤的临床研究  

Percutaneous Radiofrequency Ablation in the Treatment of Lung Cancer

作　　者：方勇[1] 倪旭东[1] 

机构地区：[1]复旦大学附属中山医院分部胸外科,上海200052

出　　处：《中国临床医学》2012年第6期619-621,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:评价CT引导射频消融治疗肺部肿瘤的缓解率,患者的中位生存时间以及生存率。方法:2005年12月—2008年12月,对73例因高龄、心肺功能差无法耐受或不适合手术治疗的非小细胞肺癌(non-small cell lung cancer,NSCLC)患者和肺转移癌患者进行CT引导射频消融术。术后根据WHO实体瘤判断标准评价疗效以及中位生存时间、总体生存率和肿瘤相关性生存率。结果:73例患者共进行78次射频消融治疗,均顺利完成。无手术相关病死发生。并发症包括气胸9例、胸痛15例、发热13例、肺内出血5例、胸膜渗出1例。平均住院天数3(2～12)d。随访至射频消融治疗后1年,肿瘤达到完全缓解共57例(86%)。NSCLC和肺转移癌的中位生存时间分别为28.33个月、24个月。至随访结束,共51例患者病死。NSCLC因肿瘤进展病死36例,肺转移癌15例。NSCLC患者1、2、3年生存率分别为84%、56%、31%;肺转移癌患者1、2、3年生存率分别为78%、37%和10%。其中Ⅰ期NSCLC患者(11例)的1、2、3年总体生存率为100%、82%、78%。结论:射频消融治疗用于无法耐受或不适合手术的NSCLC患者以及肺转移癌患者的姑息治疗时,短期疗效明显,但其远期效果有待进一步观察。Objective：To evaluate the feasibility and safety of the CT-guided percutaneous radiofrequency ablation in lung can cer. Methods：This study included 73 patients with non-small cell lung cancer（NSCLC） or lung metastatic cancer, who could not tolerate or were not suitable for operation, chemotherapy or radiation therapy because of their ages, dysfunction of heart or lung. Results： Totally 78 radiofrequency ablation operations had been done successfully. No treatment-related death happened. The complications were pneumothorax in 9 cases, pain in 15 cases, fever in 13 cases, pulmonary bleeding in 5 cases, pleural ef- fusion in 1 case. The average hospitalization time was 3 days （ 2～12 days ）. After 1 year follow-up, complete response was observed in 57 patients （86%）. The median survival time in patients with NSCLC and lung metastatic cancers was 28.33 and 24 months, respectively. Until the follow-up was finished, 51 deaths happened, including 36 patients with NSCLC and 15 pa- tients with lung metastatic cancer. The 1-year, 2-year, 3-year overall survival time in NSCLC were 84%, 56% and 31%, re- spectively while those in lung metastatic cancers were 78%, 37% and 10%, respectively. The 1-year, 2-year and 3-year overall survival time in the patients with stage I NSCLC were 100%, 82% and 78%. Conclusions： Radiofrequency ablation ope ration is appropriate for the patients with NSCLC and lung metastatic cancers, who could not tolerate or were not suitable for operation, chemotherapy or radiation therapy because of their old ages, dysfunction of heart or lung, or worse status. It is also an alternative palliative strategy for the patients with lung metastatic cancer. It can achieve good short-term effects, but the long-term result need further observation.

关 键 词：射频消融 非小细胞肺癌 肺转移癌 

分 类 号：R734.2[医药卫生—肿瘤]