氩氦靶向冷冻和联合化疗治疗晚期非小细胞肺癌219例临床研究  

Clinical study of Argon-helium targeted cryotherapy and combined chemotherapy for 219 cases of advanced non-small cell lung cancer

作　　者：李虎明 韩志海 孟激光 刘振千 李泳群 张春阳 LI Huming;HAN Zhihai;MENG Jiguang;LIU Zhenqian;LI Yongqun;ZHANG Chunyang(Department of Pulmonary and Critical Care Medicine, the Sixth Medical Center,Chinese PLA General Hospital, Beijing 100048, China)

机构地区：[1]中国人民解放军总医院第六医学中心呼吸与危重症医学科

出　　处：《转化医学杂志》2019年第4期222-225,228,共5页Translational Medicine Journal

基　　金：军队后勤科研计划重点项目(BHJ16J011)

摘　　要：目的探讨经皮穿刺氩氦靶向冷冻治疗晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床疗效,分析氩氦靶向冷冻联合化疗对肺癌局部控制及生存曲线的影响。方法219例ⅢB和Ⅳ期NSCLC患者根据治疗情况分为单纯接受氩氦靶向冷冻治疗组(118例)和氩氦靶向冷冻联合化疗组(101例),评估治疗后近期局部控制情况及生存时间,并采用Cox回归模型对联合化疗组进行多因素生存分析。结果单纯氩氦靶向冷冻治疗组与联合化疗组患者氩氦靶向冷冻冰球覆盖率差异比较无统计学意义(P>0.05);瘤体直径<4cm患者较直径≥4cm冷冻冰球覆盖率高,差异比较有统计学意义(P<0.05);氩氦靶向冷冻联合化疗组术后3个月局部有效控制情况较单纯氩氦靶向冷冻组高,差异比较有统计学意义(P<0.05);单纯氩氦靶向冷冻与联合化疗组中位生存时间分别为(15.00±1.48)个月和(20.00±2.21)个月,差异比较有统计学意义(P<0.05);对联合化疗组行多因素分析显示肿瘤大小、诊断分期及术后局部控制情况是影响远期生存率的独立危险因素(P<0.05)。结论经皮穿刺氩氦靶向冷冻联合化疗治疗晚期NSCLC的近期局部控制情况及生存时间均优于单纯氩氦冷冻治疗;肺癌分期较早、瘤体较小及近期局部控制较好者相对预后较好。Objective To explore the clinical efficacy and analysis the effects of local control status and survival curve of the patients who suffered advanced non-small cell lung cancer (NSCLC) after treatment of Argon-helium targeted cryotherapy combined with chemotherapy. Methods Two hundred and nineteen patients include ⅢB and Ⅳ phase were divided into two groups based on their treatment condition. One hundred and eighteen cases were single group who only accept the treatment of Argon-helium targeted cryotherapy, while another group of one hundred and one cases were combined group who accept the treatment combined with chemotherapy. Evaluate the quality of recent local control and survival period, and conduct forward survival analysis of multifactor through Cox regression model. Results Argon-helium targeted freezing hockey coverage between single group and combine group had no significant difference ( P >0.05). Patients whose tumor diameter less than 4 cm had a higher ice hockey coverage than those tumor diameter were equal or greater than 4 cm, difference between them had statistic significance ( P <0.05). Combined group had a better local effective control than single group at 3 months after operation, difference had statistically significance ( P <0.05). Median survival time between single group and combine group were (15.00±1.48) months and (20.00±2.21) months respectively, difference had statistically significance ( P < 0.05). After multifactor analysis to the combined group, the diagnosis phase, tumor size, and the quality of local control after operation were independent risk factors of survival ( P <0.05). Conclusion Quality of recent local control and survival time of the combined group were better than single group who were suffered advanced NSCLC. The prognosis of the lung cancer patients of combined chemo- therapy group with earlier phase, less tumor size and better recently local control were relatively better.

关 键 词：非小细胞肺癌 氩氦 冷冻治疗 化疗 COX模型 

分 类 号：R734.2[医药卫生—肿瘤]