国际肿瘤学杂志

国际肿瘤学杂志 ›› 2018, Vol. 45 ›› Issue (2): 73-76.doi: 10.3760/cma.j.issn.1673422X.2018.02.003

• 论著 • 上一篇    下一篇

CT引导射频消融同期瘤内化疗治疗Ⅲ期非小细胞肺癌的临床研究

朱勇刚,卢斌,周成伟,赵伟军,赵晓东   

  1. 315020宁波大学医学院附属医院胸外科
  • 出版日期:2018-02-08 发布日期:2018-02-28
  • 通讯作者: 赵晓东，Email: zhxido@sohu.com E-mail:zhxido@sohu.com

Clinical study of CT-guided radiofrequency ablation plus intratumoral chemotherapy for patients with stage Ⅲ non-small cell lung cancer

Zhu Yonggang, Lu Bin, Zhou Chengwei, Zhao Weijun, Zhao Xiaodong   

  1.  Department of Thoracic Surgery, Affiliated Hospital of Medical School of Ningbo University, Ningbo 315020, China
  • Online:2018-02-08 Published:2018-02-28
  • Contact: Zhao Xiaodong E-mail:zhxido@sohu.com

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摘要： 目的探讨CT引导下射频消融同时进行瘤内化疗治疗Ⅲ期非小细胞肺癌（NSCLC）的疗效及安全性。方法2014年2月至2015年5月，选取本院收治因高龄而未接受全身化疗的38例Ⅲ期NSCLC患者，采用分层随机方法将其分为实验组和对照组，每组19例。实验组于CT引导射频消融后给予瘤内化疗药物洛铂，对照组仅接受CT引导射频消融治疗，观察两组患者不良反应、术后Karnofsky功能状态（KPS）评分、1年生存率及近期疗效。结果38例患者均顺利完成治疗。实验组患者治疗后3个月有效率（89.5%∶63.2%）及治疗后6个月有效率（78.9%∶52.6%）差异均无统计学意义（P=0.124；P=0.170）。实验组与对照组KPS评分改善率分别为42.1%（8/19）和31.6%（6/19）、稳定率分别为52.6%（10/19）和52.6%（10/19）、恶化率分别为5.3%（1/19）和15.8%（3/19），差异均无统计学意义（P=0.737；P=1.000；P=0.290）。实验组患者的1年生存率高于对照组（89.5%∶73.7%），差异有统计学意义（χ2=5.573，P=0.034）。实验组患者3级内疼痛（31.6%∶42.1%）、低热（21.1%∶26.3%）、气胸（31.6%∶42.1%）、消化道反应（15.8%∶31.6%）、骨髓抑制（5.3%∶15.8%）发生率低于对照组，但差异均无统计学意义（P=0.501；P=0.703；P=0.501；P=0.252；P=0.290）。结论射频消融联合瘤内化疗治疗Ⅲ期NSCLC患者可提高短期生存率，且并未增加不良反应，长期生存率方面尚有待进一步跟踪随访。

关键词: 癌, 非小细胞肺, 导管消融术, 洛铂, 瘤内化疗

Abstract: Objective To explore the clinical efficacy and safety of CTguided radiofrequency ablation plus intratumoral chemotherapy in patients with stage Ⅲ nonsmall cell lung cancer (NSCLC). MethodsFrom February 2014 to May 2015, 38 patients with stage Ⅲ NSCLC who did not receive systematic chemotherapy due to advanced age were selected in our hospital. The patients were divided into experimental group (n=19) and control group (n=19) by stratified random method. The patients in experimental group received CTguided radiofrequency ablation plus Lobaplatin intratumoral chemotherapy, and the patients in control group only received CTguided radiofrequency ablation. The adverse events, Karnofsky performance system (KPS) scores, 1year overall survival rates and shortterm curative effects of patients in the two groups were observed. ResultsAll 38 patients completed the course of therapy successfully. The 3month response rates and 6month response rates in experimental group and control group were 89.5% vs. 63.2% and 78.9% vs. 52.6%, with no significant differences (P=0.124； P=0.170). The KPS score improvement rates were 42.1% (8/19) and 31.6% (6/19) in experimental group and control group, the KPS score stable rates were 52.6% (10/19) and 52.6% (10/19) in the two groups, and the KPS score deterioration rates were 5.3% (1/19) and 15.8% (3/19) in the two groups, with no significant differences (P=0.737; P=1.000; P=0.290). The 1year survival rate of patients in experimental group was higher than that in control group (89.5% vs. 73.7%), with a significant difference (χ2=5.573, P=0.034). The rates of less than or equal to grade 3 pain (31.6% vs. 42.1%), low fever (21.1% vs. 26.3%), aerothorax (31.6% vs. 42.1%), gastrointestinal reaction (15.8% vs. 31.6%) and bone marrow depression (5.3% vs. 15.8%) in experimental group were lower than those in control group, but the differences were not statistically significant (P=0.501; P=0.703; P=0.501; P=0.252; P=0.290). ConclusionCTguided radiofrequency ablation plus intratumoral chemotherapy for stage Ⅲ NSCLC can improve shortterm survival rate, and it does not increase the adverse reaction. While, the longterm overall survival rate has yet to be followed up.【Key words】

Key words: Carcinoma, non-small-cell lung, Catheter ablation, Lobaplatin, Intratumoral chemotherapy