摘要
目的比较2/3次冷冻-复温循环对晚期非小细胞肺癌(NSCLC)的消融效果及不良反应差异。方法回顾性分析接受2/3次冷冻-复温循环、瘤体直径≤5 cm晚期NSCLC患者的病例资料。比较分析两组患者疾病控制率及术后不良反应。结果 2014年12月到2017年6月,99例患者合计接受冷冻治疗NSCLC 107次。随访7.2～21.8个月,平均13.2个月。根据mRECST标准,3次循环冷冻治疗组术后3、6、12个月获得的疾病缓解率和疾病控制率分别为78.8%、69.2%、60.0%和98.1%、94.2%、86.0%。2次循环冷冻治疗组术后3、6、12个月获得的疾病缓解率和疾病控制率分别为70.0%、64.4%、52.3%和93.6%、88.9%、72.7%。根据不同瘤体直径,3次循环冷冻治疗组与2次循环冷冻治疗组的局部复发率分别为7.1%和17.1%(P=0.038 4,<3 cm),25.0%和28.6%(P=0.995 7,3～5 cm)。疾病缓解率分别为65.4%和59.4%(<3 cm),54.2%和43.5%(3～5 cm)。术后30 d不良反应均为1级或2级。两组相比,差异无统计学意义(P>0.05)。冷冻循环次数与气胸或胸腔积液发生率无关(P>0.05)。结论对瘤体直径<3 cm的晚期NSCLC,3次冷冻-复温循环治疗能获得较好的近期局部疗效。
Objective To compare the ablation effect and adverse reactions of twice freezing-rewarming cycle therapy with those of triple freezing-rewarming cycle therapy for advanced non-small cell lung cancer（NSCLC）. Methods The clinical data of 99 patients with advanced NSCLC（tumor diameter ≤5 cm）, who received twice（n =47, twice group） or triple（n =52, triple group） freezing-rewarming cycle therapy at authors＇ hospital, were retrospectively analyzed. The disease remission rate, disease control rate and the postoperative adverse reactions were compared between the two groups. Results From December2014 to June 2017, 99 patients received a total of 107 procedures of cryoablation treatment for NSCLC. The follow-up time ranged from 7.2 to 21.8 months, with a mean of 13.2 months. Based on mRECST standard,the disease remission rate and disease control rate at 3, 6, 12 months after treatment in triple group were78.8%, 69.2%, 60.0% and 98.1%, 94.2%, 86.0% respectively, which in twice group were 70.0%, 64.4%,52.3% and 93.6%, 88.9%, 72.7% respectively. The local recurrence rates for tumors with diameter 〈3 cm in triple group and in twice group were 7.1% and 17.1% respectively（P=0.038 4）, and for tumors with diameter of 3-5 cm in triple group and in twice group were 25.0% and 28.6% respectively（P =0.995 7）. The disease remission rates for tumors with diameter 〈3 cm in triple group and in twice group were 65.4% and 59.4%respectively, and for tumors with diameter of 3-5 cm in triple group and in twice group were 54.2% and43.5% respectively. The severity of postoperative adverse reactions belonged to grade Ⅰ or grade Ⅱ, and the difference between the two groups was not statistically significant（P〉0.05）. The number of freezing cycles bore no relationship to the incidence of pneumothorax or pleural effusion（P〉0.05）. Conclusion For the treatment of advanced NSCLC with tumor diameter 〈3 cm, triple freezing-rewarming cycle therapy can obtain better short-term local curative effect.
作者
曾健滢
施娟娟
牛涛
秦子淋
何丽华
徐克成
牛立志
ZENG Jianying;SHI Juanjuan;NIU Tao;QIN Zilin;HE Lihua;XU Kecheng;NIU Lizhi(Affiliated Fuda Cancer Hospital of Jinan University,Guangzhou,Guangdong Province 510665,China)
出处
《介入放射学杂志》
CSCD
北大核心
2018年第11期1085-1089,共5页
Journal of Interventional Radiology
基金
广东省广州市天河区科技计划项目(201604KW009)
关键词
肺肿瘤
冷冻消融
3次循环
缓解率
气胸
lung neoplasm
cryoablation
triple freezing-rewarming cycle
remission rate
pneumothorax
