冷冻消融序贯化疗治疗晚期非小细胞肺癌的疗效观察  

Clinical efficacy of argon-helium knife cryotherapy followed by chemotherapy for advanced non-small cell lung cancer

作　　者：钱建新[1] 顾小强[1] 焦晓栋[1] 王湛 武清[1] 

机构地区：[1]上海第二军医大学长征医院肿瘤科,200001

出　　处：《介入放射学杂志》2014年第7期579-583,共5页Journal of Interventional Radiology

基　　金：上海市卫生局科研计划资助项目(2009121)

摘　　要：目的探讨氩氦刀冷冻消融序贯化疗治疗晚期非小细胞肺癌(NSCLC)的近期疗效以及对远期生存的影响。方法回顾61例行氩氦刀冷冻消融序贯化疗以及同期52例单纯接受化疗的Ⅲb或Ⅳ期NSCLC患者。采用疼痛数字分级法(NRS)行疼痛评估,FACT-G量表评估生活质量(QOL)。按RECIST实体瘤疗效评价标准评价疗效,随访患者生存时间。结果 1 26例患者术前伴有局部疼痛,冷冻术后疼痛有不同程度的缓解。61例患者冷冻术后生活质量FACT-G各维度均有不同程度的改善。2与同期单纯化疗的患者比较,冷冻消融序贯化疗组肿瘤缓解率较高(34.4%比15.4%,P<0.05)。3冷冻消融序贯化疗与单纯化疗患者的中位生存时间分别为12.9个月和9.5个月,1年生存率分别为53.6%和35.4%。两组间差异有统计学意义(P<0.01)。结论氩氦刀冷冻消融为一安全、有效的肿瘤局部治疗手段,可迅速降低肿瘤负荷,缓解患者疼痛,改善生活质量。CT引导下经皮穿刺氩氦刀冷冻消融治疗肺癌可取得较好疗效,尤其对不能根治切除或不能耐受手术的晚期NSCLC患者,冷冻消融后序贯化疗的疗效优于单纯化疗,可提高患者的生存率。Objective To explore the short- term efficacy of argon- helium knife cryotherapy followed by chemotherapy in treating advanced non- small cell lung cancer （NSCLC） and to investigate its effect on the long- term survival. Methods During the period from March 2005 to March 2008, a total of 61 patients withⅢb or Ⅳ stage NSCLC received argon- helium knife cryotherapy followed by chemotherapy （study group）, and other 52 patients with Ⅲb or Ⅳ stage NSCLC were treated with chemotherapy only （control group）. The clinical data were retrospectively analyzed. The pain was evaluated by numeric rating scale （NRS） and the quality of life （QOL） was assessed by functional assessment of cancer therapy- general （FACT- G） scale. The clinical effect was evaluated according to RECIST criteria for solid tumor, and the patient’s survival time was recorded. Results （1） Twenty- six patients had local pain before the treatment, and the pain was relieved in different degrees after cryotherapy. The QOL, including all respects of FACT - G, was significantly improved after cryotherapy in all 61 patients. （2） The remission rate of the study group and the control group was 34.4% and 15.4% respectively, the difference between the two groups was statistically significant （P 〈0.05）. （3） The median survival time of the study group and the control group was 12.9 months and 9.5 months respectively, and the one- year survival rate of the study group and the control group was 53.6% and 35.4% respectively. The differences between the two groups were statistically significant （P 〈 0.01）. Conclusion Argon- helium knife cryotherapy is a safe and effective local treatment for advanced NSCLC, which can quickly reduce the tumor load, relieve the pain and improve patient’s quality of life. Cryotherapy with subsequent chemotherapy is superior to simple chemotherapy in improving the patient’s survival rate.

关 键 词：冷冻消融 化疗 非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤]