陈道花, 陈兢兢, 隋明颖, 李水秀, 崔景华, 张小波, 李静. CT引导下经皮微波消融或联合125I粒子植入治疗晚期肺癌的临床分析[J]. 循证医学, 2023, 23(4): 225-235. DOI: 10.12019/j.issn.1671-5144.2023.04.006
    引用本文: 陈道花, 陈兢兢, 隋明颖, 李水秀, 崔景华, 张小波, 李静. CT引导下经皮微波消融或联合125I粒子植入治疗晚期肺癌的临床分析[J]. 循证医学, 2023, 23(4): 225-235. DOI: 10.12019/j.issn.1671-5144.2023.04.006
    CHEN Dao-hua, CHEN Jing-jing, SUI Ming-ying, LI Shui-xiu, CUI jing-hua, ZHANG Xiao-bo, LI Jing. Clinical Analysis of CT-Guided Percutaneous Microwave Ablation Combined With 125I Seed Implantation in the Treatment of Advanced Lung Cancer[J]. Journal of Evidence-Based Medicine, 2023, 23(4): 225-235. DOI: 10.12019/j.issn.1671-5144.2023.04.006
    Citation: CHEN Dao-hua, CHEN Jing-jing, SUI Ming-ying, LI Shui-xiu, CUI jing-hua, ZHANG Xiao-bo, LI Jing. Clinical Analysis of CT-Guided Percutaneous Microwave Ablation Combined With 125I Seed Implantation in the Treatment of Advanced Lung Cancer[J]. Journal of Evidence-Based Medicine, 2023, 23(4): 225-235. DOI: 10.12019/j.issn.1671-5144.2023.04.006

    CT引导下经皮微波消融或联合125I粒子植入治疗晚期肺癌的临床分析

    Clinical Analysis of CT-Guided Percutaneous Microwave Ablation Combined With 125I Seed Implantation in the Treatment of Advanced Lung Cancer

    • 摘要:
      目的  探讨分析计算机断层扫描(computed tomography,CT)引导下经皮微波消融(microwave ablation,MWA)或联合碘125粒子(iodine-125,125I)植入治疗晚期肺恶性肿瘤的临床疗效。
      方法 共纳入44例行MWA或MWA联合125I粒子植入治疗的Ⅳ期非小细胞肺癌(non small-cell lung cancer,NSCLC)或肺转移瘤患者,按其治疗方式不同分为MWA组28例,联合组(MWA联合125I粒子植入)16例。并对两组患者近期的临床疗效、并发症、功能状态评分(Karnofsky performance status,KPS)及生存的相关因素进行比较。
      结果 MWA组、联合组的有效率分别为21.43%、56.25%(P < 0.05);并发症发生率分别为46.43%、62.50%(P>0.05);治疗后1个月,两组KPS均低于治疗前(P < 0.05);治疗后3个月,联合组的KPS评分高于本组治疗前及MWA组同期的评分(P < 0.05);生存期的相关因素进行Cox分析,治疗方式风险比(hazard ratio,HR)=0.400,95%可信区间(confidence interval,CI)0.849~0.957,P=0.048、术前KPS(HR=0.902,95%CI 0.850~0.957,P=0.001为保护因素。
      结论 CT引导下MWA联合125I粒子植入对晚期肺恶性肿瘤的治疗安全可靠,近期临床疗效尚可。

       

      Abstract:
      Objective  To investigate and analyze the clinical efficacy of computed tomography (CT)-guided microwave ablation (MWA) combined with iodine-125 (125I) seed implantation in treating lung malignant tumors.
      Methods Records of forty-four patients, who were followed up for advanced or metastatic lung cancer treated with MWA or MWA combined with 125I seed implantation from January 2015 to December 2020 in Guangdong Provincial People's Hospital, were retrospectively reviewed, 28 patients were treated with MWA(MWA group)and 16 patients were treated with MWA combined with 125I seed implantation(combined group). The short-term clinic effectiveness, complications, Karnofsky performance status (KPS) score, and factors associated with survival were compared between the two groups of patients.
      Results The effective rate was 21.43% in the MWA group and 56.25% in the combined group, P < 0.05;The complication rate was 46.43% in the MWA group and 62.50% in the combined group, P>0.05;one month after treatment, the KPS score was lower than that before treatment in both groups(P < 0.05). Three months after treatment, the KPS score in the combined group was higher than that before treatment in this group, and much higher than the MWA group scores in the same period(P < 0.05). The factors associated with survival were subjected to Cox regression, in which the protective factors were treatment modalityhazard ratio(HR)=0.400, 95% confidence interval (CI)0.849~0.957, P=0.048and preoperative KPS(HR=0.902, 95%CI 0.850~0.957, P=0.001).
      Conclusions CT-guided MWA combined with 125I seed implantation is safe and effective in the treatment of advanced and metastatic lung cancer, and the recent clinical effect is satisfactory.

       

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