CT引导下氩氦刀联合放射性粒子植入治疗非小细胞肺癌的临床疗效

目的 探讨氩氦刀联合放射性1251粒子植入技术在非小细胞肺癌(NSCLC)患者治疗中的临床应用价值.方法 选取2015年1月至2017年1月在郑州大学第五附属医院肿瘤科收治的117例NSCLC患者,根据治疗方式不同分为联合组63例和对照组54例,联合组患者在CT引导下采用氩氦刀联合放射性1251粒子植入进行治疗,对照组...

Clinical effect of argon-helium knife cryoablation combined with radioactive particle implantation in the treatment of non-small cell lung cancer

Objective To investigate the clinical application value of argon-helium knife cryoablation combined with radioactive seed implantation in the treatment of non-small cell lung cancer(NSCLC).Methods A total of 117 patients with NSCLC admitted to Oncology Department of Fifth Affiliated Hospital of Zhengzhou University from January 2015 to January 2017 were included in our study.And they were divided into the combination group(n=63)treated with CT guided argon-helium knife cryoablation combined with radioactive 125I seeds implantation and the control group(n=54)treated only with argon-helium knife ablation.The changes of blood routine indexes,tumor markers,tumor ablation target volume and CT value were observed before and 1,3,6 months after treatment.Adverse reactions during treatment and the evaluation results of efficacy were compared between the two groups.Patients were followed up for 24 months to observe the recurrence and survival rates between the two groups.Results In the combination group,seeds of(12.49±4.91)were implanted,and the X-ray exposure was(123.16±42.75)Gy.There was no significant difference in general clinical data between the two groups before treatment(P>0.05).At 1,3 and 6 months after treatment,as compared with control group the combination group showed the significantly decreased platelet count(t=3.154,3.586,2.233,P=0.027、0.019、0.034),while,there was no significant difference in white blood cell count,red blood cell count and hemoglobin level between the two groups(all P>0.05).The levels of carcinoembryonic antigen(CEA),neuron-specific enolase(NSE)and tumor volume were significantly lower in combination group than in control group at 3 and 6 months after treatment(t3=3.142,2.926 and 4.281,t6=4.094,5.382 and 4.535,all P<0.05),showing significant improvements of illness.While,the above levels showed no significant differences at 1 month after treatment between two groups(t=1.065,1.037,P=0.197,0.255).At each monitoring time,the CT value of tumor target area showed a steady downward trend(P<0.05).During the treatment,the incidence of thrombocytopenia was higher in the combination group than in the control group(47.6%or 30/63 vs.24.1%or 13/54,χ²=6.935,P=0.008),while there were no significant differences in the incidence of postoperative fever,pneumothorax,myoglobinuria,pain,bleeding and nausea and vomiting between the two groups(all P>0.05).After 6 months of treatment,the remission rate was higher in the combination group(73.0%or 46/63)than in the control group(48.1%or 26/54).The survival time and relapse-free time of the combination group were longer than those of the control group[(21.81±4.31)months vs.(18.93±5.94)months,(20.48±5.76)months vs.(16.93±7.14)months,Log Rankχ²=8.229 and 9.656,(P=0.004 and 0.002)].Conclusions Argon-helium knife Cryoablation combined with radioactive seed implantation can effectively control the local progression of NSCLC,reduce the risk of tumor recurrence,and has high safety.