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微波消融联合化疗治疗晚期非小细胞肺癌。

Microwave ablation in combination with chemotherapy for the treatment of advanced non-small cell lung cancer.

作者信息

Wei Zhigang, Ye Xin, Yang Xia, Zheng Aimin, Huang Guanghui, Li Wenhong, Ni Xiang, Wang Jiao, Han Xiaoying

机构信息

Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwuweiqi Road, Jinan, 250021, Shandong, China,

出版信息

Cardiovasc Intervent Radiol. 2015 Feb;38(1):135-42. doi: 10.1007/s00270-014-0895-0. Epub 2014 May 9.

Abstract

PURPOSE

To verify whether microwave ablation (MWA) used as a local control treatment had an improved outcome regarding advanced non-small cell lung cancer (NSCLC) when combined with chemotherapy.

METHODS

Thirty-nine patients with histologically verified advanced NSCLC and at least one measurable site other than the ablative sites were enrolled. Primary tumors underwent MWA followed by platinum-based doublet chemotherapy. Modified response evaluation criteria in solid tumors (mRECIST) and RECIST were used to evaluate therapeutic response. Complications were assessed using the National Cancer Institute Common Toxicity Criteria (version 3.0).

RESULTS

MWA was administered to 39 tumors in 39 patients. The mean and median diameters of the primary tumor were 3.84 cm and 3.30 cm, respectively, with a range of 1.00-9.00 cm. Thirty-three (84.6 %) patients achieved a partial response. No correlation was found between MWA efficacy and clinicopathologic characteristics. For chemotherapy, 11 patients (28.2 %) achieved a partial response, 18 (46.2 %) showed stable disease, and 10 (25.6 %) had progressive disease. The overall objective response rate and disease control rate were 28.2 and 74.4 %, respectively. The median progression-free survival time was 8.7 months (95 % CI 5.5-11.9). The median overall survival time was 21.3 months (95 % CI 17.0-25.4). Complications were observed in 22 (56.4 %) patients, and grade 3 adverse events were observed in 3 (7.9 %) patients.

CONCLUSIONS

Patients with advanced NSCLC could benefit from MWA in combination with chemotherapy. Complications associated with MWA were common but tolerable.

摘要

目的

验证作为局部控制治疗手段的微波消融(MWA)与化疗联合应用时,对于晚期非小细胞肺癌(NSCLC)是否能改善治疗效果。

方法

纳入39例经组织学证实的晚期NSCLC患者,且除消融部位外至少有一个可测量部位。对原发肿瘤进行MWA,随后进行铂类双联化疗。采用实体瘤改良反应评估标准(mRECIST)和RECIST来评估治疗反应。使用美国国立癌症研究所通用毒性标准(第3.0版)评估并发症。

结果

对39例患者的39个肿瘤进行了MWA。原发肿瘤的平均直径和中位数直径分别为3.84 cm和3.30 cm,范围为1.00 - 9.00 cm。33例(84.6%)患者达到部分缓解。未发现MWA疗效与临床病理特征之间存在相关性。对于化疗,11例(28.2%)患者达到部分缓解,18例(46.2%)病情稳定,10例(25.6%)病情进展。总体客观缓解率和疾病控制率分别为28.2%和74.4%。无进展生存期的中位数为8.7个月(95%可信区间5.5 - 11.9)。总生存期的中位数为21.3个月(95%可信区间17.0 - 25.4)。22例(56.4%)患者观察到并发症,3例(7.9%)患者观察到3级不良事件。

结论

晚期NSCLC患者可从MWA与化疗联合应用中获益。与MWA相关的并发症常见但可耐受。

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