CT引导下经皮肺穿刺氩氦靶向治疗肺转移癌  

Percutaneous Targeted Lung Metastatic Cancer Ar-He Cryoablation Guided by CT

作　　者：王洪武[1] 段蕴铀[1] 张燕群[1] 冯华松[1] 聂舟山[1] 颜霞[1] 陆海英[1] 赵秀琴[1] 韩志海[1] 田树平[1] 

机构地区：[1]海军总医院氩氦刀肿瘤治疗中心,北京100037

出　　处：《海军总医院学报》2003年第3期152-156,共5页Journal of Naval General Hospital of PLA

摘　　要：目的　观察经皮肺穿刺氩氦靶向治疗肺转移癌的可行性和安全性。方法　采用CT引导下 ,经皮肺穿刺氩氦靶向治疗肺转移癌。结果　 4 0例肺转移癌患者 80个病灶接受了氩氦刀治疗。 5 1个直径≤ 4cm肺内肿块 ,冰球覆盖肿瘤面积达 98 9% ,显效率可达 10 0 0 % ,而 2 9例直径 >4cm的肿块 ,冰球覆盖肿瘤面积达 87 0 % ,显效率达 86 2 % ,表明氩氦靶向治疗肺癌的局部疗效主要取决于肿块的大小。手术过程较安全 ,无 1例术中死亡。术后并发症较少 ,4 6 8%患者术后有少量咯血 ,2 5 8%有气胸 ,19 4 %有胸腔积液 ,19 4 %术后咳嗽加剧 ,16 1%有发热。术后 1周 6 7 7%的瘤体呈空洞样改变 ,体积增大 ;术后 1月瘤体缩小 ,11 1%病灶完全吸收 ,2 2 2 %还有空洞样改变。 3月后 ,瘤体进一步缩小 ,9 5 %的病灶 (<3cm)完成吸收。绝大多数密度变低 ,仅有 19%呈空洞样改变。 6月以后 ,瘤体变化不大。随访 15个月 ,中位生存期为 5个月。根据寿命表法计算 ,氩氦刀术后 6个月生存率为 6 6 % ,15个月为 5 0 %。结论　氩氦刀比较安全 ,疗效可靠。Objective The aim of retrospective review was to assess the efficacy and safety of the percutaneous targeted cryosurgical system. Methods Percutaneous targeted lung cancer was guided by CT. The percentage of iceball covered lung mass was measured after cryoablation immediately, and the complications, and survive rate were observed. Results 40 patients with 80 lesions underwent cryosurgery in the lung metastatic cancer from Augest, 2001 to Nov, 2002. the percentage of iceball covered lung mass was 98.9% in 51 lesions(≤4 cm in diameter), the efficacy rate was 100.0%, while the percentage of iceball covered lung mass was 87%, the efficacy rate was 86.2% in 29 lesions(>4 cm in diameter), which suggested that the local efficacy was depended on the mass in diameter. Slight haemoptysis occurred in 46.8% of patients, fever in 16.1%, pneumothorax in 25.8% and pleural effusion in 19.4% after cryoablation. The mass enlarged and cavity developed after 1 week of cryosurgery. It was stable or increases after 6 months. A median survive period was 5 months follow up 15 months. The survive rate was 66% at 6 months and 50% at 15 months. Conclusion Percutaneous targeted lung cancer cryoablation is a minimally noninvasive, successful treatment in lung metastatic cancer.

关 键 词：氩氦靶向治疗系统 肺癌 计算机体层摄影术 CT 

分 类 号：R734.2[医药卫生—肿瘤]