关键词: 非小细胞肺癌, 全身静脉化疗, 氩氦冷冻消融

Abstract:

Objective To explore the differences of clinical efficacy and safety between Argon helium cryoablation combined with intraveneous chemotherapy and intravenous chemotherapy,argon helium cryoablation in the treatment of advanced non small cell lung cancer(NSCLC). Methods The clinical materials of 89 patients with advanced NSCLC and failure in radiotherapy and (or) chemotherapy treated in Department of Interventional Radiology of Cancer Hospital of Tianjin Medical University were analyzed,and they were divided into chemotherapy alone group(n=26),cryoablation alone group(n=30),and cryoablation combined with chemotherapy group(combination group,n=33).The adverse reactions and complications after 2 months of treatment were analyzed.FACT-G scale was used to evaluate the life quality of the patients before and 2 months after treatment.After the treatment,every 1-2 months the follow-up with enhanced CT was performed,the objective response rate of the tumor was evaluated by modified response evaluation criteria in solid tumors (mRECIST).The progression-free survival and overall survival were analyzed with Kaplan-Meier method,and Log-rank test was used to identify the differences in the survival rate. Results Compared with chemotherapy alone group,the incidence rates of bone marrow suppression,gastrointestinal reaction,liver and kidney function damage of the patients in combination group had no significant differences (P>0.05).Two months after treatment,compared with before treatment, the total scores of life quality of the patients in three groups were improved in different degrees,and there were significant differences between before treatment and after treatment in combination group and cryoablation alone group(P<0.05),but there was no significant difference between before treatment and after treatment in chemotherapy alone group(P>0.05).Two months after treatment,the tumor response rates(CR+PR)in combination group and cryoablation alone group were higher than that in chemotherapy alone group,and there was no significant difference between combination group and cryoablation alone group(P>0.05).The median follow-up period was 17 months,the median progression free survival of the patients in three groups were 11.1 months in combination group,6.9 months in cryoablation alone group,and 6.1 months in chemotherapy alone group;there were significant differences between combination group and other two groups(P<0.05).The median survival of the patients in combination group,cryoablation alone group and chemotherapy alone group were 16 months,13 months and 10 months;there were significant differences between combination group and other two groups(P<0.05). Conclusion Cryoablation combined with chemotherapy is a safe and effective method in the treatment of the patients with advanced NSCLC after failure in radiotherapy and (or) chemotherapy,and its curative effect is better than intravenous chemotherapy and cryoablation alone.

Key words: non small cell lung cancer, intravenous chemotherapy, Argon helium cryoablation