CT评价单纯氩氦刀冷冻术联合放疗粒子治疗非小细胞肺癌的疗效

目的探讨CT评价单纯氩氦刀冷冻术及联合^125I粒子植入治疗非小细胞肺癌（NSCLC）疗效的价值。方法应用单纯氩氦刀冷冻术（A组，22例）及氩氦刀冷冻术联合^125I粒子植入（B组，20例）治疗NSCLC患者共42例。以胸部CT扫描动态观察治疗前、后病灶的变化，包括治疗时的冰球覆盖率、治疗后肿瘤的大小、密度并进行临床疗效评价。结果42例均置刀成功。CT显示两组低密度冰球的平均覆盖率均大于80％。两组中直径3～5cm与〉5cm病灶的疗效差异均有统计学意义（P均〈0．05）。A、B组在术后1、3、6、12个月有效率分别为63．64％（14／22）和65．00％（13／20）、72．73％（16／22）和75．00%（15／20）、54．55％（12／22）和85．00％（17／20）、59．09％（13／22）和80．00％（16／20）。结论氩氦刀冷冻术能有效治疗失去手术机会的NSCLC；联合^125I粒子植入能有效地控制残余肿瘤，进一步提高有效率；CT可准确定位、追踪复查评价治疗效果。

CT evaluation on the therapeutic effect of single Argon-Helium cryoablation and combined with particle radiation for non-small cell lung cancer

Objective To observe the value of CT in evaluation on the treatment effect of non-small cell lung cancer(NSCLC) by using single percutaneous targeted Argon-Helium cryoablation and the combining therapy with 125I implantation.Methods Forty-two patients with NSCLC were collected and divided into group A(Argon-Helium cryoablation therapy,n=22) and B(Argon-Helium cryoablation therapy+125I implantation,n=20).The tumor changes were observed with CT,including ice-ball coverage rate,the dynamic changes of the tumor size and density and the therapeutic efficacy.Results All targeted Argon-Helium cryoablation were successful guided by CT.The average ice-ball coverage rate was larger than 80% in both group.There was statistical difference of therapeutic effect between tumors with diameter of 3—5 cm and >5 cm(both P<0.05) in 2 groups.The effective rate of 1,3,6 and 12 months after treatment in group A and B was 63.64%(14/22) and 65.00%(13/20),72.73%(16/22) and 75.00%(15/20),54.55%(12/22) and 85.00%(17/20),59.09%(13/22) and 80.00%(16/20),respectively.Conclusion Argon-Helium cryoablation therapy is an effective method for NSCLC patients who missed operation opportunity,and combination with radiation particles can effectively control residual tumor.CT is valuable in tumor location and following up the changes after treatment,playing an important role in the intervening therapy and prognosis assessment of NSCLC.