A pilot study on combination of cryosurgery and (125)iodine seed implantation for treatment of locally advanced pancreatic cancer

AIM： To study the therapeutic value of combination o cryosurgery and 125iodine seed implantation for locally advanced pancreatic cancer. METHODS： Forty-nine patients with locally advanced pancreatic cancer （males 36, females 13）, with a median age of 59 years, were enrolled in the study. Twelve patients had liver metastases. In all cases the tumors were considered unresectable after a comprehensive evaluation. Patients were treated with cryosurgery, which was performed intraoperatively or percutaneously unde guidance of ultrasound and/or computed tomography （CT）, and 125iodine seed implantation, which was performed during cryosurgery or post-cryosurgery under guidance of ultrasound and/or CT. A few patients received regional celiac artery chemotherapy. RESULTS： Thirteen patients received intraoperative cryosurgery and 36 received percutaneous cryosurgery Some patients underwent repeat cryosurgery. 125Iodine seed implantation was performed during freezing procedure in 35 patients and 3-9 d after cryosurgery in 14 cases. Twenty patients, 10 of whom had hepaticmetastases received regional chemotherapy. At 3 mo after therapy, CT was repeated to estimate tumor response to therapy. Most patients showed varying degrees of tumor necrosis. Complete response （CR） of tumor was seen in 20.4% patients, partial response （PR）, in 38.8%, stable disease （SD）, in 30.6%, and progressive disease （PD）, in 10.2%. Adverse effects associated with cryosurgery included upper abdomen pain and increased serum amylase. Acute pancreatitis was seen in 6 patients one of whom developed severe pancreatitis. All adverse effects were controlled by medical management with no poor outcome. There was no therapy-related mortality. During a median follow-up of 18 mo （range of 5-40）, the median survival was 16.2 mo, with 26 patients （53.1%） surviving for 12 mo or more. Overall, the 6-, 12-, 24- and 36-mo survival rates were 94.9%, 63.1%, 22.8% and 9.5%, respectively. Eight patients had survival of 24 mo or more. The     

125 I粒子植入联合汉防己甲素治疗局部晚期非小细胞肺癌患者的疗效及安全性观察

目的：探讨放射性125 I粒子联合汉防己甲素（ Tet）治疗局部晚期非小细胞肺癌（ NSCLC）的疗效及安全性。方法将76例Ⅲa～Ⅲb期NSCLC患者随机分为两组各38例。两组均在CT引导下将125 I粒子植入靶区,放射处方剂量为110 Gy。观察组在植入125 I粒子当天口服Tet,连服3个月。比较两组的疗效和毒性反应。结果76例患者均顺利完成治疗。 D100（112．4±12．3）Gy,D90（148．7±22．5）Gy,平均剂量（238．9±11．6）Gy。中位随访时间为21个月,观察组和对照组治疗6个月时的总有效率分别为86．8％、65．8％,1年生存率分别为84．2％、63．2％,中位生存时间分别为26、18个月（P均＜0．05）。125I粒子植入的主要并发症为气胸及咯血,对照组出现1级晚期放射性肺损伤8例,观察组未出现晚期放射性肺损伤。结论125 I粒子联合Tet治疗局部晚期NSCLC近期疗效好、局部控制率高、患者生存率高、并发症少、无明显不良反应,值得临床应用。     

经皮冷冻治疗结直肠癌肝转移

背景：结直肠癌肝转移的手术切除率低,其他疗法效果亦欠佳。目的：探讨经皮冷冻治疗结直肠癌肝转移的疗效和安全性。方法：于超声或CT引导下,对326例不能手术切除的结直肠癌肝转移患者行经皮冷冻治疗,术后定期随访。结果：326例患者共接受526次经皮冷冻治疗。治疗后3个月,基线CEA水平升高者中77．6％降至正常范围。280例接受CT随访者中,冷冻病灶完全反应（CR）者14．6％,部分反应（PR）41．1％,稳定（SD）24.3％,进展（PD）20．0％。中位随访期为36食月（7—62个月）,复发率为41．7％。全部病例中位存活期为29个月（3～62个月）。治疗后第1、2、3、4、5年存活率分别为78％、62％、41％、34％和23％：肿瘤直径≤3cm、肝右叶肿瘤、冷冻前CEA≤10μg／L、冷冻后原先升高的CEA降至正常、冷冻治疗2～3次和冷冻后行经导管肝动脉化学栓塞（TACE）治疗者存活率较高。严重并发症发生率为5．2％。结论：经皮冷冻治疗结直肠癌肝转移安全、有效,可作为肿瘤不能手术切除者的替代治疗手段。     

Interstitial permanent implantation of 125I seeds as salvage therapy for re-recurrent rectal carcinoma

Purpose  To assess the feasibility, efficacy, and morbidity of ¹²⁵I seeds interstitial permanent implant as salvage therapy for re-recurrent rectal cancer. Methods and materials  From September 2003 to October 2007, ¹²⁵I seeds implant procedures were performed under CT or ultrasound guidance for thirteen patients with locally re-recurrent rectal carcinoma. The minimal peripheral doses (MPD) of ¹²⁵I seeds implanted ranged from 120 to 160 Gy, with a median MPD of 140 Gy to total decay. Three patients also received two to four cycles of chemotherapy after seed implantation. Results  After a median follow-up of 10 months (range 3–45), the pain-free interval was 0–14 months with a median of 7 months (95% CI: 3–11 months). The response rate of pain relief was 46.2% (6/13). Local control was 3–14 months with a median of 7 months (95% CI: 3.5–10.5 months). The 1- and 2-year local control rates were 14.4% and 0%, respectively. Three (23.1%) patients died of local recurrence; seven (53.8%) patients died of local recurrence and metastases; one (7.7%) patient died of metastases. Two (15.4%) patients survived to follow-up. At the time of analysis, the median survival was 10 months (95% CI: 3.9–16.1 months). The 1- and 2-year actuarial overall survival rates were 46.2% and 11.5%, respectively. Two (15.4%) patients experienced a grade 4 toxic event. Seed migration to the pelvic wall was observed in one (7.7%) patient. There was no associated neuropathy. Conclusion   ¹²⁵I seed implantation is feasible, effective, and safe as a salvage or palliative treatment for patients with re-recurrent rectal cancer.     

经皮冷消融治疗局部进展性胰腺癌的可行性

目的 前瞻性观察经皮冷消融治疗的不良反应、肿瘤变化及近期疗效,探讨该技术治疗局部进展性胰腺癌的可行性.方法 2008年9月至2009年9月共59例局部进展性胰腺癌患者采用氩/氦为基础的冷冻系统,在超声引导下行经皮冷消融治疗.将冷冻探针插入胰腺肿块的中心,做2次循环冷冻,每次冷冻5 min,温度为-160℃,然后复温,持续10 min.检测治疗前和治疗后7 d的血清淀粉酶活性;冷消融后每4～6周行CT扫描评价肿瘤变化;应用Kaplan-Meier法计算生存率.结果 59例患者共有76个活检证实的肿瘤,位于胰头部56个、胰体部7个、胰尾部13个.肿瘤中位大小4.5 cm,19例伴肝转移.术后发生腹痛45例(76.3%),发热29例(49.2%),血淀粉酶升高34例(57.6%),严重并发症(腹腔内出血、胰漏、肠梗阻和冷冻探针针道转移)5例(8.5%),无冷消融相关性死亡.中位住院时间21 d.2例(3.4%)获得完全缓解,23例(39.0%)获得部分缓解,30例(50.8%)疾病稳定,4例(6.8%)疾病进展.中位存活期8.4个月;3、6、12个月存活率分别为89.7%、61.1%和34.5%.结论 超声引导下的经皮冷消融是一种安全可行的局部进展性胰腺癌微创治疗技术.     

Role of fine needle aspiration cytology and endoscopic biopsy in the preoperative assessment of pancreatic and peripancreatic malignancies

Sixty-seven of 207 patients with pancreatic and peripancreatic malignancies underwent preoperative fine needle aspiration cytology (FNA), and 24 patients underwent intraluminal endoscopic biopsies. All patients had confirmation of the diagnosis of malignancy either at operation, autopsy, or by clinical follow-up. FNA of liver metastases was positive for malignancy in 12 of 12 patients. FNA of the pancreas was performed on 44 patients with pancreatic adenocarcinoma and 11 patients with other pancreatic or peripancreatic malignancies. The diagnosis of cancer was established by FNA in 32 of 44 (72.4%) patients with pancreatic adenocarcinoma and 1 of 11 patients (9.1%) with other pancreatic or peripancreatic malignancies. In the patients with pancreatic adenocarcinoma, 17 of 18 patients (94.4%) who had no operative intervention, 12 of 18 (66.7%) patients who had palliative bypass procedures, and 3 of 8 (37.5%) patients resected had positive FNA. Eighteen of 24 patients (75%) who underwent intraluminal endoscopic biopsies, and 11 of 15 (73.3%) with ampullary carcinoma were positive. We believe that FNA is of limited value in the diagnosis of small resectable tumors of the pancreas as it identified cancer in only 3 of 8 patients in whom it was employed. False negative FNA may delay the diagnosis and treatment of pancreatic malignancies. Patients in whom there is a high index of suspicion of pancreatic or peripancreatic malignancy based on clinical presentation, CT scan, or ERCP assessment do not require preoperative, histologic proof of malignancy prior to pancreaticoduodenectomy. Patients deemed to be unresectable or candidates for bypass on the basis of the size of the tumors or suspected liver metastases should be considered for FNA cytology, which is mainly successful under these circumstances.     

Combination of cryosurgery and Iodine-125 seeds brachytherapy for lung cancer

It has been proven that radioactive seeds such as Iodine-125 seeds implantation is a highly effective treatment for patients with localized cancer, such as lung cancer. It may increase the effectiveness of cryosurgery for lung cancer with the combination of Iodine-125 seed implantation into edge of the cryoablation zone. Percutaneous cryosurgery and Iodine-125 seed implantation are mutual complementation; both have been proved to be safe and effective modality for unresectable lung cancer, especially for centrally located lung cancer. Well-designed, randomized and control study both in the laboratory and in the clinical about this option are needed before the conclusive evidence submits.KEY WORDS : Lung cancer, cryosurgery, cryoablation, Iodine-125 seeds     

Intraoperative radiofrequency ablation combined with 125 iodine seed implantation for unresectable pancreatic cancer

AIM: To evaluate the feasibility, efficacy and safety of intraoperative radiofrequency ablation (RFA) combined with 125 iodine seed implantation for unresectable pancreatic cancer. METHODS: Thirty-two patients (21 males and 11 females) at the age of 68 years (range 48-90 years) with unresectable locally advanced pancreatic cancer admitted to our hospital from January 2006 to May 2008 were enrolled in this study. The tumor, 4-12 cm in diameter, located in pancreatic head of 23 patients and in pancreatic body...     

To evaluate the efficacy and safety of 125I seed implantation in SCLC as second line therapy

This study aimed to evaluate the efficacy and safety of iodine 125 (¹²⁵I) radioactive seed implantation for small cell lung cancer at the limited stage of relapse as second line therapy. We collected 6 patients with recurred limited stage small cell lung cancer, who got pathological diagnosis after a bronchoscopic biopsy and then received standard first line treatment, combined chemotherapy and radiotherapy, including prophylactic cranial irradiation. These recurred small cell lung cancer patients got ¹²⁵I seed implantation treatment as second line therapy, if the treatment not good responsive or the disease got rapid progress, we used the second line chemotherapy as salvage treatment. Clinical data of these patients were collected and short-term effects were observed. The follow-up period lasted for 42 months. All the patients tolerated the procedure of ¹²⁵I radioactive seed implantation very well. We followed up the patients to 42 months. Five patients got complete remission and 1 patient got partial remission at 1 month after implantation. The objective response rate was 100%. The median survival time was 26 months. And median progression-free survival was 12 months after ¹²⁵I treatment. And about the complications, 1 patient suffered from the light aerothorax, 1 patient had a little hemoptysis. Our study showed that ¹²⁵I seed implantation as second line regimen in small cell lung cancer that recurred locally after first line treatment was effective and safe. That could improve the overall survival and progression-free survival only comparing to the second line chemotherapy. Therefore ¹²⁵I seed implantation as brachytherapy protocol is a promising method and can be applied as second line treatment to control the locally recurred small cell lung cancer.     

肝癌的冷冻治疗

冷冻疗法己成为治疗不能手术切除肝癌的重要手段。冷冻方法可选择手术中冷冻，切除或不切除肿瘤、腹腔镜下冷冻，或在超声、CT下，经皮冷冻。作为一局部治疗，冷冻具有超越其他治疗方法的若干优点：仅消融肝内肿瘤组织，而少伤及正常组织；由于大血管流动血流的温热作用，冷冻可安全地治疗临近大血管的肝肿瘤；冷冻比手术更适宜治疗肝多发性肿瘤。冷冻联合肝动脉化疗栓塞（TACE）、酒精注射或^125碘粒子植入，有相辅相成的作用。对于冷冻在肝癌治疗中应用，可归结如下：①〈5cm，尤其〈3cm的肝癌，数目不超过3个，可以手术中冷冻或经皮冷冻。②〉5cm的肝癌，先作TACE，再给予经皮冷冻。③〉5cm，边缘不整，预计冷冻不完全的肝癌，可予手术中或经皮冷冻，同时在冷冻区周边部注射酒精或植入^125碘粒子。     

超声内镜引导下定向植入放射性125Ⅰ粒子治疗胰腺癌的临床研究

目的探讨超声内镜引导下定向植入放射性粒子治疗胰腺癌的临床可行性。方法在超声内镜引导下对10例手术无法切除的胰腺癌患者行125I粒子定向植入术,通过19G穿刺针植入粒子。首先,根据肿瘤大小确定植入粒子数量。其次,在超声内镜引导下植入粒子。术后1个月进行CT随访。结果每例患者植入的粒子数量4~12枚不等。植入术均安全完成,术后未发生严重并发症。9例疼痛患者3d内均感缓解。术后1个月时随访,4例为疼痛部分缓解,3例为疼痛轻度缓解;1例肿瘤部分缓解,7例患者肿瘤无明显进展。1例患者2个月后随访发现肝脏转移,另1例患者3个月后病情恶化死亡。结论超声内镜引导下定向植入放射性粒子安全、可靠,并发症少,值得推广。     

Malignant mediastinal lymphadenopathy detected by staging EUS in patients with pancreaticobiliary cancer

BACKGROUND: In patients with pancreatic cancer, the presence of malignant mediastinal lymphadenopathy (MML) would preclude definitive resection. A recent study suggested routine evaluation for mediastinal lymph-node metastases in all patients being evaluated for pancreaticobiliary masses. In our practice, we routinely assess for mediastinal lymph-node metastases in all patients undergoing EUS for pancreaticobiliary cancer. METHODS: We retrospectively evaluated the presence of MML by EUS-guided FNA (EUS-FNA) in 160 consecutive patients with a definite diagnosis of pancreaticobiliary cancer (pancreatic and periampullary cancers) who underwent EUS-FNA by a single operator from 2000 to 2004. Lymph nodes that were round and hypoechoic with sharp margins were considered suspicious and were sampled by FNA. RESULTS: Of the 160 patients included in this study, 78 had peripancreatic lymph nodes (49%: 95% CI[41%, 58%]), 25 had celiac lymph nodes (16%: 95% CI[10%, 22%]), and 14 patients had mediastinal lymph nodes (9%: 95% CI[4%, 13%]) that were suspicious for malignancy by morphologic criteria. In 8 of 14 patients with suspicious mediastinal lymph nodes, FNA documented MML in 5%: 95% CI[2%, 8%]. Only one of these 8 patients with MML had other sites of documented distant metastases by CT and/or positron emission tomography scans. However, 7 of 8 patients had locally advanced cancers. CONCLUSIONS: MML is detected by staging EUS-FNA in 5% of patients with pancreaticobiliary cancer. Because of its important implications, endosonographers should routinely assess for MML in patients who undergo staging EUS for pancreaticobiliary malignancy.     

CT-guided implantation of radioactive 125I seed in advanced non-small-cell lung cancer after failure of first-line chemotherapy

Purpose

We investigated implanting computed tomography (CT)-guided ¹²⁵I seed to treat locally advanced non-small-cell lung cancer (NSCLC) after chemotherapy failure.

Methods

From January 2005 to July 2010, we recruited 69 patients with locally advanced NSCLC who had each had first-line chemotherapy four to six times but had progressive disease; 34 received ¹²⁵I seed implantation with second-line chemotherapy (Group A) and 35 received second-line chemotherapy only (Group B).

Results

Mean follow-up was 32 months (range 5–56 months). Overall 2-year local control rate for existing lung lesions was Group A: 39.9 %; Group B: 12.5 % (P < 0.05). The 1-, 3-year, and median overall survival was 68.7 and 20.8 % at 17.4 months in Group A; and 45.1 and 18.7 % at 11.3 months in Group B, respectively (P > 0.05). Local 3-, 24-month, and median progression-free survival was Group A: 100 and 79.1 % at 11 months; Group B: 76.5 and 18.7 % at 7.3 months, respectively. The groups did not significantly differ in treatment toxicity. Chest pain remission was Group A: 82.1 % (23/28); Group B: 30.8 % (8/26) (P < 0.05). Group A showed no radiation-related pneumonia, esophagitis, bronchial fistulae, or life-threatening morbidity.

Conclusion

CT-guided radioactive seed ¹²⁵I implantation procedure is safe and well tolerated in treating locally advanced NSCLC, with few complications. It has good local control rate and can relieve symptoms without increasing side effects.     

CT arterial portography in the staging of pancreatic malignancy.

BACKGROUND: Detection of metastatic liver disease and malignant involvement of major peripancreatic vessels is important to determine resectability of pacreatic malignancy. Computed tomography with arterial portography (CTAP) is the most sensitive method for detection of colorectal liver metastases; it can also detect malignant vascular involvement. We have assessed CTAP in patients with pancreatic cancer considered suitable for resection after standard ultrasonography (US) and computed tomography (CT) examination. METHOD: CTAP was performed in 18 patients (8 with a biliary stent). All patients had previous US and CT with no clear evidence of irresectability. Findings of CTAP were compared with the prior CT and with findings at operation or clinical progress. RESULTS: CTAP suggested liver metastases in 7 patients. Three were confirmed at operation or at follow-up (sensitivity for detection of metastases in CT negative patients of 75%). There were 4 false-positive assessments (specificity, 71%). One further patient developed liver metastases within 6 mo after resection (1 false-negative). Nine patients had vascular involvement at operation. There was 1 false-positive and one false-negative assessment (sensitivity, 89% and specificity, 89%). CTAP detected vascular involvement in 4 patients in whom it was not detected by CT. CONCLUSION: This preliminary study suggests that CTAP is a sensitive test for detection of liver metastases and vascular involvement in patients with pancreatic malignancy. This invasive test should be reserved for patients who are considered operable on the basis of other preoperative tests.     

18F-FDG PET/CT对显像阳性原发性肝癌125I粒子植入治疗疗效价值的评估

目的:探讨<'18>F-FDG PET/CT对显像阳性的原发性肝癌行<'125>I粒子植入治疗疗效价值的评价.方法:原发性肝癌患者39例,共55个肿瘤病灶,均于放射性<'125>I粒子植入治疗前确定病灶为<'18>F-FDG PET/CT显像阳性;放射性<'125>I粒子植入治疗后2 mo行PET/CT检查评价疗效,之...     

CT arterial portography in the staging of pancreatic malignancy

Summary Background. Detection of metastatic liver disease and malignant involvement of major peripancreatic vessels is important to determine resectability of pacreatic malignancy. Computed tomography with arterial portography (CTAP) is the most sensitive method for detection of colorectal liver metastases; it can also detect malignant vascular involvement. We have assessed CTAP in patients with pancreatic cancer considered suitable for resection after standard ultrasonography (US) and computed tomography (CT) examination. Method. CTAP was performed in 18 patients (8 with a biliary stent). All patients had previous US and CT with no clear evidence of irresectability. Findings of CTAP were compared with the prior CT and with findings at operation or clinical progress. Results. CTAP suggested liver metastases in 7 patients. Three were confirmed at operation or at follow-up (sensitivity for detection of metastases in CT negative patients of 75%). There were 4 false-positive assessments (specificity, 71%). One further patient developed liver metastases within 6 mo after resection (1 false-negative). Nine patients had vascular involvement at operation. There was 1 false-positive and one false-negative assessment (sensitivity, 89% and specificity, 89%). CTAP detected vascular involvement in 4 patients in whom it was not detected by CT. Conclusion. This preliminary study suggests that CTAP is a sensitive test for detection of liver metastases and vascular involvement in patients with pancreatic malignancy. This invasive test should be reserved for patients who are considered operable on the basis of other preoperative tests.     

Staging chest computed tomography and positron emission tomography in patients with pancreatic adenocarcinoma: utility or futility?

Objectives

This study was conducted to determine if routine staging chest computed tomography (CT) or positron emission tomography (PET) scanning alters the clinical management of patients with newly diagnosed pancreatic adenocarcinoma.

Methods

All new pancreas cancers seen in medical oncology, radiation oncology and surgery from 1 June 2008 to 20 June 2010 were retrospectively reviewed. Patients with metastatic disease on chest CT or PET, that had been unsuspected on initial imaging, were identified.

Results

Pancreatic adenocarcinoma was present in 247 consecutive patients. Abdominal CT demonstrated metastases in 108 (44%) and localized disease in 139 (56%) patients. Chest CT and PET were not performed in 15 (11%) of these 139 patients. In the remaining 124 patients, CT imaging suggested resectable disease in 46, borderline resectable disease in 52 and locally advanced disease in 26 patients. Chest CT demonstrated an unsuspected lymphoma in one patient with borderline resectable disease and PET identified extrapancreatic disease in two patients with locally advanced disease. Chest CT and PET added no information in 121 (98%) of the 124 patients.

Conclusions

The addition of chest CT and PET to high-quality abdominal CT is of little clinical utility; additional sites of metastasis are rarely found. As the quality of abdominal imaging declines, the yield from other imaging modalities will increase. Dedicated pancreas-specific abdominal CT remains the cornerstone of initial staging in suspected or biopsy-proven pancreatic cancer.     

125I Brachytherapy in Locally Advanced Nonsmall Cell Lung Cancer After Progression of Concurrent Radiochemotherapy

To investigate the safety and effectiveness of computed tomography (CT)-guided ¹²⁵I seed implantation for locally advanced nonsmall cell lung cancer (NSCLC) after progression of concurrent radiochemotherapy (CCRT).We reviewed 78 locally advanced NSCLC patients who had each one cycle of first-line CCRT but had progressive disease identified from January 2006 to February 2015 at our institution. A total of 37 patients with 44 lesions received CT-guided percutaneous ¹²⁵I seed implantation and second-line chemotherapy (group A), while 41 with 41 lesions received second-line chemotherapy (group B).Patients in group A and B received a total of 37 and 41 first cycle of CCRT treatment. The median follow-up was 19 (range 3–36) months. After the second treatment, the total response rate (RR) in tumor response accounted for 63.6% in group A, which was significantly higher than that of group B (41.5%) (P = 0.033). The median progression-free survival time (PFST) was 8.00 ± 1.09 months and 5.00 ± 0.64 months in groups A and B (P = 0.011). The 1-, 2-, and 3-year overall survival (OS) rates for group A were 56.8%, 16.2%, and 2.7%, respectively. For group B, OS rates were 36.6%, 9.8%, and 2.4%, respectively. The median OS time was 14.00 ± 1.82 months and 10.00 ± 1.37 months for groups A and B, respectively (P = 0.059). Similar toxicity reactions were found in both groups. Tumor-related clinical symptoms were significantly reduced and the patients’ quality of life was obviously improved.CT-guided ¹²⁵I seed implantation proved to be potentially beneficial in treating localized advanced NSCLC; it achieved good local control rates and relieved clinical symptoms without increasing side effects.     

Current management of locally advanced pancreatic cancer

Almost 30% of patients with pancreatic cancer present with large, locally advanced tumors in the absence of distant metastases. Because surgical resection is frequently contraindicated by vascular invasion, locally advanced pancreatic cancer has a dismal prognosis with a 6-10-month median survival. Recent advances in the multimodality treatment of other gastrointestinal malignancies have not altered the management of patients with locally advanced pancreatic cancer, a clinical dilemma reflected by the number of nonrandomized trials and anecdotal reports addressing this difficult disease. Our review summarizes the current status of aggressive surgical resection and neoadjuvant chemoradiation for locally advanced pancreatic cancer and suggests a treatment algorithm for patients with this disease based upon published clinical evidence.     

从胰腺癌治疗探讨进展期癌症治疗策略

进展性或转移性胰腺癌患者预后恶劣。化疗是目前主要治疗方法。但无论是吉西他滨单用还是与其他药物联合应用,均不能有效延长患者生存期。以冷冻消融为主的综合治疗,可以延长进展性或转移性胰腺癌患者生存期。这一结果提示,采用将经皮冷冻（C）（125碘粒子植入）、肿瘤血管（微血管）介入（C）和联合免疫治疗（C）组合起来,个体化应用（P）,形成＂3C＋P模式＂,可作为治疗进展性肿瘤的新策略。