目的：评价CT引导射频消融（RFA）治疗不能手术切除或拒绝手术的早期非小细胞肺癌（NSCLC）的有效性、安全性及局部控制效果。方法2007年3月—2010年3月对60例早期NSCLC患者进行CT引导下68次RFA。全组患者病理学分型为：鳞状细胞癌23例（38.3%），腺癌31例（51.7%），大细胞癌2例（3.3%），鳞腺癌4例（6.7%）。病灶直径平均大小3.8 cm（1.8～6.8）。观察总体生存率、肿瘤特异性生存率及局部无进展生存率。结果全组病例均能完成RFA，平均消融时间为35 min（18～63 min），术中常见并发症是气胸17例（28.3%），无围手术期死亡。中位局部无进展生存（local progression-free survival， LPFS）时间28个月，中位生存时间为32个月，局部无进展生存率1、2、3年分别为94.6%、83.1%、73.6%。结论 CT引导RFA治疗不能手术切除或拒绝手术的早期NSCLC安全、有效，可明显提高局部无进展生存率。%Objective To evaluate the safety, efficacy and local control effect of CT- guided radiofrequency ablation (RFA) in treating non-small-cell lung cancer (NSCLC) that is inoperable or the surgical treatment is refused by the patient. Methods Between March 2007 and March 2010 at authors’ hospital, a total of 68 procedures of CT-guided RFA were carried out in 60 patients with early stage NSCLC. The patients included 37 males and 23 females with a mean age of 68.5 years. Pathologically, the lesions included squamous cell carcinoma (n=23, 38.3%), adenocarcinoma (n=31, 51.7%), large cell carcinoma (n=2, 3.3%) and adeno-squamous carcinoma (n=4, 6.7%). The mean diameter of the lesions was 3.8 cm (1.8-6.8 cm). The overall survival rate, cancer-specific survival rate and local progression-free survival rate were evaluated. Results RFA procedure was well tolerated by all patients with an average ablation time of 35 min (18-63 min). The main intraprocedural complication was pneumothorax (n=17, 28.3%). No death occurred during perioperative period. The median local progression-free survival time was 28 months, the median survival time was 32 months, and the one-, 2- and 3-year local progression-free survival rate were 94.6%, 83.1%and 73.6%, respectively. Conclusion For patients with inoperable NSCLC and patients with NSCLC who refuse to receive surgery, CT-guided RFA is a safe and effective treatment. This therapy can significantly improve the local progression-free survival rate.
展开▼
