CT引导下冷极射频消融联合化放疗治疗老年局部晚期非小细胞肺癌

目的探讨CT引导经皮冷极射频消融联合化放疗治疗老年局部晚期非小细胞肺癌（NSCLC）的疗效。方法回顾性分析2005年12月至2009年3月采用冷极射频消融联合化放疗治疗老年局部晚期非小细胞肺癌30例资料,选择同期条件相同采用常规化放疗治疗局部晚期NSCLC28例作对照;比较两组病人的KPS、局部控制率、局部复发率、生存率。结果治疗组和对照组的KPS改善率分别为53.33%和32.14%,局部控制率分别为73.33%和46.43%;治疗组KPS评分稍优于对照组,但无显著性差异（χ^2=2.65,P〉0.05）。局部复发率治疗组显著低于对照组（20%v46.43%;χ^2=6.18,P〈0.05）。中位生存期治疗组16.6个月,对照组14.1个月;1、2年生存率治疗组稍高于常规组（63.53%v53.50%,31.99%v29.13%）,但两组间比较无统计学意义（χ^2=0.33,P〉0.05）。结论射频消融联合化放疗可有效地控制局部病灶的进展,降低不可切除NSCLC的局部复发率,改善病人功能状态。

Combination of CT-guided cool-tip radiofrequency ablation and chemoradiotherapy for the treatment of locally advanced non-small cell lung cancer in elderly

Objective To evaluate the clinical efficacy of CT-guided cool-tip radiofrequency ablation and chemoradiotherapy for the treatment of locally advanced non-small cell lung cancer in elderly.Methods Thirty patients with locally advanced non-small cell lung cancer（the treatment group,group A）were treated by combination of chemoradiotherapy and percutaneous cool-tip radiofrequency ablation from Dec.2005 to May 2003.The efficacy was compared with those of 28 patients who received conventional chemotherapy and/or radiotherapy（the control group,group B）in the same period.Results The treatment group and control group of KPS improvement rates were 53.33% and 32.14%,local control rates were 73.33% and 46.43%;the treatment group KPS was slightly better than the control group,but no significant difference（χ^2=2.65,P〉0.05）.The local recurrence rate of the primary treatment group was significantly lower than the control group （46.43% v 20%;χ^2=6.18,P〈0.05）.The median survival time was 16.6 months in the treatment group,14.1 months in the control group;1,2-year survival rate was slightly higher than the conventional group（63.33% v 53.57%,30% v 17.86%）.There was not statistically different in 1,2-year survival rates.Conclusion Combined chemoradiotherapy and percutaneous cool-tip radiofrequency ablation by controllable cool-tip needle can decrease local recurrence and improve performance status for locally advanced non-small cell lung cancer in elderly.