RESUMO
Objective To investigate the safety and curative effect of CT-guided percutaneous cryoablation in treating recurrent tumors in pelvic cavity and retroperitoneal space.Methods A total of 100 patients with recurrent tumors in pelvic cavity or retroperitoneal space were included in this study.CT-guided percutaneous cryoablation treatment was carried out in all patients.Results ① Of the 100 patients,complete cryoablation treatment was performed in 9 and palliative cryoablation treatment was adopted in 91.The following-up time ranged from 3 years to 11 years.The one-,3-and 5-year survival rates were 87.0％ (87/100),17％ (17/100) and 9％ (9/100) respectively.The pain relief rate after cryoablation treatment was 84.0％ (70/83).② Contrast-enhanced CT scan performed one month after cryoablation treatment showed that complete cryoablation was seen in 9 patients,presenting as no enhancement in the tumor frozen area on CT image;palliative cryoablation was seen in 91 patients,the ablation extent ≥90％ was obtained in 48 patients,the ablation extent of 80-90％ in 25 patients,the ablation extent of 70-80％ in 12 patients,the ablation extent of 60-70％ in 4 patients,and the ablation extent ＜60％ in 3 patients.③ Postoperative complications included local infection (n=3),which was cured after anti-infective therapy;intestinal fistula at upper rectum (n=1),which was gradually healed after enterostomy;transient dysuresia (n=5),which was recovered through retention catheterization for 3-5 days;fever lasting 3-5 days;and skin frostbite (n=3),which was cured after symptomatic treatment.Conclusion For the treatment of recurrent tumors in pelvic cavity and retroperitoneal space,CT-guided percutaneous cryoablation is quite safe.Complete cryoablation is very helpful for improving local tumor control and prolonging survival time.
RESUMO
Objective To explore the short- term efficacy of argon- helium knife cryotherapy followed by chemotherapy in treating advanced non- small cell lung cancer (NSCLC) and to investigate its effect on the long- term survival. Methods During the period from March 2005 to March 2008, a total of 61 patients withⅢb or Ⅳ stage NSCLC received argon- helium knife cryotherapy followed by chemotherapy (study group), and other 52 patients with Ⅲb or Ⅳ stage NSCLC were treated with chemotherapy only (control group). The clinical data were retrospectively analyzed. The pain was evaluated by numeric rating scale (NRS) and the quality of life (QOL) was assessed by functional assessment of cancer therapy- general (FACT- G) scale. The clinical effect was evaluated according to RECIST criteria for solid tumor, and the patient’s survival time was recorded. Results (1) Twenty- six patients had local pain before the treatment, and the pain was relieved in different degrees after cryotherapy. The QOL, including all respects of FACT - G, was significantly improved after cryotherapy in all 61 patients. (2) The remission rate of the study group and the control group was 34.4% and 15.4% respectively, the difference between the two groups was statistically significant (P <0.05). (3) The median survival time of the study group and the control group was 12.9 months and 9.5 months respectively, and the one- year survival rate of the study group and the control group was 53.6% and 35.4% respectively. The differences between the two groups were statistically significant (P < 0.01). Conclusion Argon- helium knife cryotherapy is a safe and effective local treatment for advanced NSCLC, which can quickly reduce the tumor load, relieve the pain and improve patient’s quality of life. Cryotherapy with subsequent chemotherapy is superior to simple chemotherapy in improving the patient’s survival rate.