经皮微波凝固疗法治疗肺癌的临床应用

目的　探讨经皮经肺微波凝固治疗周围型肺癌的临床疗效、CT影像的变化及不良反应。方法　使用针式单极微波辐射天线 ,CT引导下经皮经肺穿刺周围型肺癌 ,以 2 4 5 0MHz的微波 ,6 5W辐射 6 0s,对原发性肺癌 8例、转移性肺癌 12例 ,共 2 0例患者的 2 8个病灶进行治疗。结果　随访 3～ 2 4个月 ,16例患者健在。全部肿块均缩小 ,缩小 5 0 %以上 13个病灶 ,病灶消失 3例 ,有效率5 7.1%。CT表现为即刻凝固灶呈约 3.5cm× 2 .5cm的软组织影 ,1周后凝固区域内见气化灶 ,外周有高密度反应区 ,1个月后凝固区进一步缩小 ,3个月后实变 ,1年后几乎消失 ,治疗后细胞学证实肿瘤组织坏死。此治疗方法无副作用及并发症。结论　经皮微波凝固疗法治疗周围型肺癌是高效、微创、安全的新方法。

Percutaneous microwave coagulation therapy for lung cancer

OBJECTIVE: To evaluate the clinical effect, CT image changes and side-effects of percutaneous microwave coagulation therapy for lung cancer. METHODS: CT-guided percutaneous puncture was performed using a needle mono-pole microwave antenna with 65W, 2 450 MHz microwave delivered in 60 seconds to 20 peripheral lung cancer patients, including 8 suffering from primary lung cancer and 12 metastatic lung cancer (totally 28 lesions). RESULTS: Sixteen patients were alive after having been followed-up for 3 approximately 24 months. All patients showed nodules decreased in size. Diminution of over 50% was observed in 13 nodules and 3, completely disappeared. The overall response rate was 57.1%. Ellipsoid shadow 3.5 cm x 2.5 cm across was observed by CT in lesions immediately after coagulation. Gasification within the coagulated area was observed in a week with a high density in the peripheral region. Consolidation was observed in 3 months and the lesion disappeared 1 year later. Complete tumor necrosis was proved by biopsy. No side-effects or complications were observed. CONCLUSION: Percutaneous microwave coagulation therapy is a new safe treatment for lung cancer, giving marked effect but minimum trauma.