微波消融序贯化疗治疗晚期非小细胞肺癌的免疫学效应观察  

Immunological effect of CT-guided percutaneous microwave coagulation therapy for advanced nonsmall cell lung cancer

作　　者：高云姝[1] 李露嘉[1] 李翊[1] 庄兴俊[1] 

机构地区：[1]中国人民解放军第401医院,青岛266071

出　　处：《中华肺部疾病杂志（电子版）》2013年第6期25-27,共3页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：青岛市公共领域科技支撑计划课题(11-2-3-5-(7)-nsh)

摘　　要：目的探讨冷循环微波消融序贯化疗治疗晚期非小细胞肺癌（NSCLC）的近期疗效和免疫学效应。方法对58例晚期NSCLC行微波凝固治疗，1周后序贯化疗（方案为多烯紫杉醇75mg／m2＋顺铂30mg／m2，1～3d，21天为一周期，4周期为一疗程），治疗前后采血检测免疫指标，胸部增强CT动态观察前后变化。结果58例NSCLC微波凝固治疗7d后细胞毒性T淋巴细胞（CTL）活性升高30例，升高率51．7％。1周后增强CT显示90％的肿块有10％-50％不同程度的缩小，完全坏死率达100％者36例、达80％以上者5例。化疗1疗程后行CT评价，完全缓解（CR）5．2％（3／58）、部分缓解（PR）34．5％（20／58）、病变稳定（SD）51．7％（30／58）、病变进展（PD）8．6％（5／58）；微波凝固序贯化疗患者临床获益率达91．4％。随访最短6月，最长24月，中位生存时间为13．2月，1年生存率为49．3％。结论CT引导下冷循环微波消融系统治疗肺癌是一种安全、有效的肿瘤局部治疗手段。微波凝固治疗即可降低肿瘤负荷，还可提高机体免疫，提高综合治疗的疗效。Objective To evaluate the efficacy and immunological effect of advanced non-small cell lung cancer（NSCLC） after treatment with CT-guided percutaneous microwave coagulation therapy. Methods 58 patients with advanced NSCLC were received percutaneous microwave coagulation therapy followed by chemotherapy one week later. The chemotherapy regimen was PC protocol. The immunological markers of nature killer cell （ NK）, CD4, CD8, and CD4/CD8 were detected before and after the treatment. All patients were available for follow-up. Results The activity of NK was increased in 42 of 58 cases （ 72.4% ） received percutaneous microwave coagulation therapy, while 51.7 % （30/58） cases showed an increase in the activity of cytotoxic Tlymphocyte（CTL）. One week after the treatment, CT scan revealed that 5 cases showed 100% necrosis regions and 36 cases showed 80% necrosis areas within the tumor sites. Two cycles of chemotherapy, effective efficacy was evaluated： the rates of complete remission（CR） , partial remission（PR） , stable disease （SD） , and progressive disease（PD） were CR 5.2% （3/58） , PR 34.5% （20/58） , SD 51.7% （30/58） , PD 8.6% （5/58）respectively. The clinical benefit rate was 91.4%. The follow-up ranged from 6 months to 24 months. The median survival duration was 13.2. The one year survival duration was 49.3%. Conclusion CT- guided percutaneous microwave coagulation therapy was effective, mini-invasive, and safe for the treatment of lung cancer.

关 键 词：冷循环微波消融系统 化疗 非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤]