Immunocryosurgery for basal cell carcinoma: results of a pilot, prospective, open-label study of cryosurgery during continued imiquimod application

Background/aim  Theoretical considerations support the combination of cryosurgery and topical imiquimod to treat basal cell carcinomas (BCC). The aim of the present study was to test the feasibility and efficacy of 'cryosurgery during continued imiquimod application' ('immunocryosurgery') to treat 'high-risk-for-recurrence' BCCs.
Methods  Thirteen patients with 21 biopsy-proven tumours (4 of 21 relapses after prior surgery) were included. After 2–5 weeks (median, 3) of daily 5% imiquimod cream application, the tumours were treated by liquid N₂ cryosurgery (spray, two cycles, 10–20 s) and imiquimod was continued for additional 2–12 weeks (median, 4). The outcome after at least 18 months of follow-up (18–24 months) is currently reported.
Results  Nineteen of 21 tumours responded promptly to immunocryosurgery; two tumours required additional treatment cycles to clear. Thus, the clinical clearance rate was 100%. Only 1 of 21(5%) tumour relapsed after at least 18 months of follow-up (cumulative efficacy: 95%).
Conclusions  'Immunocryosurgery' is a promising non-surgical combination modality to treat 'high-risk-for-recurrence BCCs'. Initial evidence is suggestive of an at least additive effect of the two combined modalities. Further studies comparing immunocryosurgery directly with cryosurgery and imiquimod monotherapies will confirm the reported results.     

氩氦刀冷冻治疗原发性肝癌的初步临床研究

背景与目的：近年来氩氦刀冷冻治疗肝癌发展迅速,本研究旨在通过回顾性分析,评价氩氦刀冷冻治疗无法手术切除的原发性肝癌的临床疗效。方法：选择124例经氩氦刀冷冻治疗的原发性肝癌患者．根据巴塞罗那分期分成早期、中期及进展期肝癌组,以治疗后患者的临床表现、局部病灶CT变化、AFP下降情况、术后并发症的发生及平均生存时间作为评价指标。结果：氩氦刀冷冻治疗肝癌后患者的并发症少,82．6％的患者术后AFP降低,92．3％的肿瘤缩小或保持不变。截止至2008年4月．仍有14例患者生存．110例患者死亡。早期、中期及进展期肝癌组的中位生存时间分别为31．25个月、17．41个月、6．82个月。结论：对于无法切除的中晚期肝癌,氩氦刀治疗的并发症少．有一定的疗效。     

Cryosurgery in Tachycardia Treatment

Cryosurgical techniques have become established and acceptable therapy in the treatment of resistant arrhythmias. In this report, both experimental and clinical data are presented describing the results of various cryosurgical techniques used at the Cardiac Rhythm Disturbance Center in Lithuania, USSR.     

低温手术过程多维传热有限元分析

目的 通过有限元分析,给出低温手术过程组织三维瞬态温度场;考察人体血液灌注和代谢产热对其影响,为优化设计冷刀提供参考。方法 充分考虑组织物性和内热源的非线性,使用基于有限容积法的大型商业有限元软件Ansys求解描述低温手术过程组织传热问题的经典生物传热方程。结果 考虑血液灌注和代谢产热后,组织局部降／复温速率降低、所经历的最低温度绝对数值减少;对应时刻,组织内局部温度梯度增加;相同手术方案下,组织内冻结区域减小,且冰球生长过程减慢。结论 人体血液灌注和代谢产热对低温手术过程影响显著,体外实验由于无法模拟血液灌注和代谢产热效果而对冷刀的优化设计作用有限,必须进行在体实验以优化冷刀及其相应的低温手术方案。     

The acute remedy of malignant central airway obstruction

Objective： To explore the palliative methods to patients with central airway obstruction due to advanced malignancies. Methods： Twenty-seven patients with carcinous airway obstruction and respiratory distress were emergency remedied, including 12 cases with atelectasis and 23 with pulmonary infection. Soft cryoablated probe of CO2 and/or reticulate endobronchial stent with filmed titanium alloy were placed to the neoplasm following by bronchofibroscope. Results： Totally there were 21 patients achieved completely remission, including airway obstruction, respiratory distress and pulmonary infection remission, and 3 cases got partial remission. Meanwhile there were 3 cases died, in which one was happened during the period of endobronchial stent making, another one with heavy airway obstruction died due to asphyxia 24 h after the operation of bronchofibroscope examination, and the last one with knob invaded died because of hemoptysis and asthema secondarily 36 h after stent placed. Conclusion： The emergency remedy using soft cryoablated probe of CO2 and/or reticulate endobronchial stent with filmed titanium alloy placed to the neoplasm following by bronchofibroscope to patients with malignant central airway obstruction was a effective salvage method and could prolong patients＇ lifespan for more subsequent therapeutic opportunities.     

氩氦刀冷冻治疗荷瘤兔肝脏肿瘤的CT表现及病理分析

[目的]探讨冷冻治疗荷瘤兔肝脏肿瘤的CT与病理表现。[方法]两组试验兔行氩氦刀冷冻治疗，其中荷瘤冷冻治疗组（A组）17只，正常肝冷冻对照组（B组）12只。分别在术前、术后1周、2周、3周、4周行CT平扫和增强检查，将影像学表现与相应时期标本病理进行比较分析。[结果]A、B两组在术后1周、2周、3周均表现为消融区低密度、无强化，消融区边缘呈环形强化，但其强化的形态有所不同。术后4周，两组消融区平扫均表现为低密度区；强化扫描时，B组边缘强化环消失，而A组部分边缘未见强化，部分边缘仍见强化，且强化环较前明显扩大，病理提示强化部分有残瘤形成。[结论]治疗后4周的影像学特点是评价肝脏肿瘤冷冻消融治疗效果的重要依据。