Background and objective: TACE, Ar-He target cryosurgery and radioactive seeds implantation are the mainly micro-invasive methods in the treatment of lung cancer. This article summarizes the survival quality after treatment, the clinical efficiency and survival period, and analyzes the advantages and shortcomings of each methods so as to evaluate the clinical effect of non-small cell lung cancer with multiple minimally invasive treatment.
Methods: All the 139 cases were non-small cell lung cancer patients confirmed by pathology and with follow up from July 2006 to July 2009 retrospectively, and all of them lost operative chance by comprehensive evaluation. Different combination of multiple minimally invasive treatments were selected according to the blood supply, size and location of the lesion. Among the 139 cases, 102 cases of primary and 37 cases of metastasis to mediastinum, lung and chest wall, 71 cases of abundant blood supply used the combination of superselective target artery chemotherapy, Ar-He target cryoablation and radiochemotherapy with seeds implantation; 48 cases of poor blood supply use single Ar-He target cryoablation; 20 cases of poor blood supply use the combination of Ar-He target cryoablation and radiochemotheraoy with seeds implantation. And then the pre- and post-treatment KPS score, imaging data and the result of follow up were analyzed.
Results: The KPS score increased 20.01 meanly after the treatment. Follow up 3 years, 44 cases of CR, 87 cases of PR, 3 cases of NC and 5 cases of PD, and the efficiencywas 94.2%. Ninety-nine cases of 1 year survival (71.2%), 43 cases of 2 years survival (30.2%), 4 cases with over 3 years survival and the median survival was 19 months. Average survival was (16 +/- 1.5) months. There was no severe complications, such as spinal cord injury, vessel and pericardial aspiration.
Conclusion: Minimally invasive technique is a highly successful, micro-invasive and effective method with mild complications. To non-small cell lung cancer, we can improve the middle and long term clinical effect by using the different combination of multiple minimally invasive treatments according to the patient's condition.
背景与目的: 动脉内栓塞化疗、氩氦刀靶向冷冻及放化疗粒子植入是目前治疗肺癌的主要微创技术，本文通过对患者治疗后生存质量、临床有效率和生存期进行总结，并对每项技术自身优势和应用局限性进行分析。本研究旨在探讨多种微创治疗技术联合应用治疗晚期非小细胞肺癌的临床疗效。
方法: 回顾性分析2006年7月-2009年7月经病理证实并完成随访的139例患者，综合评价均已失去外科手术切除机会。其中原发病灶102个，纵隔、肺内及胸壁转移病灶37个，依据病灶血供情况及病灶大小、位置等选择不同微创治疗技术组合，其中靶动脉超选择栓塞化疗、氩氦刀靶向冷冻及放化疗粒子植入相结合治疗富血肿瘤71个，单纯氩氦刀靶向冷冻治疗乏血肿瘤48个，氩氦刀靶向冷冻结合放、化疗粒子植入治疗乏血肿瘤20个。对患者治疗前后KPS评分、影像资料及随访结果进行对比分析。
结果: 治疗后患者KPS评分平均提高20.01，随访3年，CR 44例，PR 87例，NC 3例，PD 5例，有效率94.2%。1年生存99例（71.2%），2年生存43例（30.2%），4例存活3年以上，中位生存19个月，平均生存（16±1.5）个月。无脊髓损伤、血管及心包穿刺损伤等严重并发症。
结论: 微创技术操作成功率高、创伤小、并发症轻、疗效肯定。就原发性非小细胞肺癌而言，根据患者具体情况，有针对性地采用不同微创技术相结合实施治疗，相互补充、协同作用，将进一步提高患者中、远期临床疗效。