经皮全面冷冻治疗Ⅳ期肺癌生存分析

目的探讨CT引导下经皮全面冷冻治疗Ⅳ期肺癌的术后不良反应及疗效。方法对2004年8月至2011年11月广州复大医院收治的54例Ⅳ期肺癌患者进行回顾性分析,患者分为全面冷冻组31例(同时冷冻原发灶及转移灶),对照组23例(不冷冻或只冷冻转移灶),对术后不良反应进行观察,并比较两组患者中位生存期。结果所有冷冻组患者手术都顺利进行,氩氦刀冷冻术中、术后未发现心搏骤停或呼吸衰竭等严重并发症。术后不良反应包括咯血、气胸、心动过缓、术后低血压、发热、血小板减少和咳嗽。全面冷冻组患者生存时间(中位生存期14个月)显著长于对照组(中位生存期7个月,P=0.0009)。全面冷冻组患者中接受多次冷冻的患者生存期(中位生存期18个月)长于接受单次冷冻的患者(中位生存期14个月,P=0.0376)。结论经皮全面冷冻术安全性较好并能显著延长Ⅳ期肺癌患者的生存期,多次全面冷冻对生存期的延长作用更加显著。

Analysis of survival time in patients by percutaneous comprehensive cryoablation for stage Ⅳ lung cancer

Objective To investigate the adverse events and therapeutic effect of comprehensive cryoablation treatment in stage 1V lung cancer. Methods From August 2004 to November 2011, 54 patients with stage IV lung cancer were enrolled into this study. 31 patients received comprehensive cryoablation treatment （ cryoablation and iodine-125 seed implantation to the primary tumor） , and 23 patients had palliative treatment （ no cryoablation to the primary tumor）. Both the safety of the procedure and median survival for stage IV lung cancer were assessed during a 6.5 year follow-up period. Results No severe adverse events such as cardiac arrest or respiratory failure were observed during or post eryoablation. Adverse effects including transient hemoptysis, pneumothorax, bradyeardia, hypotension, fever, thrombocytopenia and cough. The survival time of comprehensive cryoablation group was significantly longer than the control group （median survival time was 14 months vs. 7 months, P = 0. 0009 ）. Multiple comprehensive eryoablation treatments played an important role in improving the survival time of stage IV lung cancer patients （ median survival time was 18 months vs. 14 months, P = 0. 0376）. Conclusion Adverse events of comprehensive cryoablation in stage IV lung cancer are slight and can be resolved by appropriate treatment, and also can improve the survival time of the IV lung cancer patients, multiple comprehensive cryoablation treatments may further prolong the survival of the IV lung cancer patients than single treatments.