| 梁曦月,王猛,高飞,董军强,潘元威,孟园园,郭鹏,周雅淑,周志刚,路太英.冷冻消融治疗晚期非小细胞肺癌的近期疗效及安全性[J].中国介入影像与治疗学,2023,20(3):148-152 |
| 冷冻消融治疗晚期非小细胞肺癌的近期疗效及安全性 |
| Short-term efficacy and safety of cryoablation for advanced non-small cell lung cancer |
| 投稿时间：2022-09-09 修订日期：2022-12-24 |
| DOI：10.13929/j.issn.1672-8475.2023.03.005 |
| 中文关键词: 癌,非小细胞肺 体层摄影术,X线计算机 冷冻消融 |
| 英文关键词:carcinoma, non-small-cell lung tomography, X-ray computed cryoablation |
| 基金项目: |
| 作者 | 单位 | E-mail | | 梁曦月 | 郑州大学第一附属医院肿瘤科, 河南 郑州 450052 | | | 王猛 | 郑州大学第一附属医院放射科, 河南 郑州 450052 | | | 高飞 | 郑州大学第一附属医院放射科, 河南 郑州 450052 | | | 董军强 | 郑州大学第一附属医院放射科, 河南 郑州 450052 | | | 潘元威 | 郑州大学第一附属医院放射科, 河南 郑州 450052 | | | 孟园园 | 郑州大学第一附属医院肿瘤科, 河南 郑州 450052 | | | 郭鹏 | 郑州大学第一附属医院肿瘤科, 河南 郑州 450052 | | | 周雅淑 | 郑州大学第一附属医院肿瘤科, 河南 郑州 450052 | | | 周志刚 | 郑州大学第一附属医院放射科, 河南 郑州 450052 | | | 路太英 | 郑州大学第一附属医院肿瘤科, 河南 郑州 450052 | fccluty@zzu.edu.cn |
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| 中文摘要: |
| 目的 观察冷冻消融治疗晚期非小细胞肺癌（NSCLC）的近期疗效及安全性。方法 回顾性分析37例接受CT引导下冷冻消融治疗（康博刀）的NSCLC患者（TNM Ⅲb~Ⅳ期），以常见不良事件评价标准（CTCAE）5.0版统计不良反应；对比消融前、消融后7天及1个月实验室指标；根据改良实体瘤疗效评价标准（mRECIST）评估消融后1个月疗效。结果 37例患者均顺利完成消融治疗。消融后10例（10/37，27.03%）发生胸腔积液，9例（9/37，24.32%）咯血，6例（6/37，16.22%）气胸，5例（5/37，13.51%）穿刺点疼痛，均为CTCAE 1、2级不良反应，对症处理后均好转；无CTCAE 3级及以上不良反应。消融后7天，相比消融前，白细胞计数、中性粒细胞计数、纤维蛋白原、D-二聚体、C反应蛋白均升高，凝血酶原时间（PT）延长（P均<0.05）。消融后1个月癌胚抗原（CEA）、鳞状上皮细胞癌抗原（SCCAg）均较消融前降低，白细胞计数、中性粒细胞计数、C反应蛋白较消融后7天回落（P均<0.05）；37例中，完全缓解14例、部分缓解17例、疾病稳定5例、疾病进展1例，治疗有效率为83.78%（31/37），疾病控制率为97.30%（36/37）。结论 康博刀冷冻消融治疗晚期NSCLC近期疗效确切，且安全性好。 |
| 英文摘要: |
| Objective To observe the short-term efficacy and safety of cryotherapy for advanced non-small cell lung cancer (NSCLC). Methods Thirty-seven patients with NSCLC (TNM Ⅲb-Ⅳ) who undwent CT-guided cryoablation (Kangbo knife) were retrospectively analyzed. The adverse reactions were statistically analyzed using the common terminology criteria for adverse events (CTCAE) version 5.0. The laboratory test parameters were compared before operation, 7 days and 1 month after operation, and the therapeutic effect was assessed according to the modified response evaluation criteria in solid tumors (mRECIST) 1 month after operation. Results The ablation procedure was completed successfully in all 37 patients. After operation, pleural effusion was observed in 10 cases (10/37, 27.03%), while hemoptysis,pneumothorax and puncture site pain were noticed in 9 (9/37, 24.32%), 6 (6/37, 16.22%) and 5 (5/37, 13.51%) cases, respectively. All were CTCAE grade 1 and 2 adverse reactions and improved after symptomatic treatment. No CTCAE grade 3 or above adverse reactions occurred. Compared with those before ablation, the white blood cell count, neutrophil count, fibrinogen, D-dimer and C-reactive protein increased and prothrombin time (PT) prolonged 7 days after ablation (all P<0.05). One month after ablation, carcinoembryonic antigen (CEA) and squamous cell carcinoma antigen (SCCAg) decreased compared with those before ablation, while the white blood cell count, neutrophil count and C-reactive protein decreased compared with those 7 days after ablation (all P<0.05). Complete remission was achieved in 14 cases, partial remission in 17 cases, stable disease in 5 cases and progressive disease in 1 case, with the response rate of 83.78% (31/37) and the disease control rate of 97.30% (36/37). Conclusion Kangbo knife cryoablation had definite short-term efficacy and good safety for advanced NSCLC. |
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