【摘要】 目的探讨已丧失手术机会的中晚期非小细胞肺癌经皮肺穿刺氩氦刀靶向冷冻消融术的可行性及其临床疗效。方法在CT引导下,根据影像资料提示的肿瘤大小,方位选用不同大小及数目的氩氦刀靶向刺入不能手术切除的非小细胞肺癌瘤体内进行同步冷冻消融,并根据随机的原则将50例非小细胞肺癌分为A组(单纯氩氦刀组)14例,B组(氩氦刀+化疗组)16例,C组(氩氦刀+化疗+放疗组)20例进行治疗。结果经氩氦刀冷冻消融治疗后,CT值较术前下降超过30HU占66.0%。术后1周、1、3、6及12个月经复查CT示,术后1周肿瘤体积增大占100%(50/50),1、3、6及12个月有效率(RR=CR+PR)分别为57.1%、56.3%和70%;71.4%、75%、80%;78.5%、81.3%、85%;64.3%、81.3%和85%。3组病人经不同方案治疗后症状、体征的有效率分别为:A组:-40%、57.14%、71.42%、88.57%和71.79%;B组:-40.91%、59.09%、77.27%、92.68%和88.64%;C组-36.21%、68.97%、84.48%、94.82%和89.66%。3组病人经不同方案治疗后KPS评分提高20分者A、B、C3组分别为:64.28%、25.5%和20%。结论经皮穿刺氩氦刀靶向冷冻消融治疗中晚期非小细胞肺癌是一种方法可行,临床疗效确切,副作用小的有效方法。结合放、化疗可进一步提高有效率。更多还原

【Abstract】 [Objective] To explore the possibility and it′s clinical curative effect of patients with advanced non-small cell lung cancer(NSCLC) who had already lost the surgical operation opportunity and were treated with percutaneous targeted Argon-Helium cryoablation therapy. [Methods] 50 cases were selected and divided into A(Argon-Helium cryoablation therapy), B(Argon-Helium cryoablation + chemotherapy), and C(Argon-Helium cryoablation + chemo-radiotherapy) groups. According to the image data of patients, CT scanning was usd to guide the Argon-Helium probe to stab into body of cancer. [Results] CT values lowered 30 HU about in 66.0% cases after treatment. CT scanning was used after 1 week, 1, 3, 6, and 12 months. The volume of cancer was larger than before after 1 week. The effectiveness(RR=CR+PR) was 57.1%, 56.3%, 70%; 71.4%, 75%, 80%; 78.5%, 81.3%, 85%; 64.3%, 81.3% and 85% respectively. The effectiveness of symptoms in three groups was A: -40%, 57.14%, 71.42%, 88.57%, 71.79%; B: -40.91%, 59.09%, 77.27%, 92.68%, 88.64%; C: -36.21%, 68.97%, 84.48%, 94.82%, 89.66% respectively; The KPS score increased 20 accounted for 64.28%, 25.5%, 20% respectively in A, B, C groups. [Conclusions] Argon-Helium targeted cryoablation therapy was a practicable and effective technique with slight side-effects, which combined with radiotherapy and chemotherapy can further effectiveness.更多还原