Clinic study on cool-tip radiofrequency ablation combined with chemotherapy for advanced non-small-cell lung cancer / 肿瘤

ABSTRACT

Objective: To explore the therapeutic effects of cool-tip radiofrequency ablation (C-RFA) combined with chemotherapy for advanced non-small-cell lung cancer (NSCLC). Methods: Forty-six patients with advanced NSCLC were treated with C-RFA combined with three cycles of chemotherapy (gemcitabine 1 000 mg/m2, on day 1 and day 8 and cisplatin 100 mg/m2 on day 1). The tumor volume and density were evaluated by chest CT enhancing scan 3 months after C-RFA therapy. All the patients were followed up for 12 months. Natural killer cell (NKc) activity and T cell subgroups in peripheral blood were determined by flow cytometry before and at 1 week after C-RFA therapy. Forty-six NSCLC patients who received three-dimensional conformal radiotherapy (3D-CRT) combined with chemotherapy was regarded as control group. The irradiation dosage of 3 D-CRT was 62-70 Gy. The chemotherapeutic regimen was the same as C-RFA group. Results: After three months of C-RFA therapy, the chest CT imaging showed that the areas of tumor lesions were decreased to different extent in majority cases and the tumor density decreased significantly. There were 7cases of complete response (CR), 29 cases of partial response (PR), 5 cases of stable disease (SD), and 5 cases of progressive disease (PD). The total effective rate (CR + PR) was 78.26%. The one year survival rate was 67.4%. For 3D-CRT group, there were 5 cases of complete response, 25 cases of partial response, 9 cases of stable disease, and 7 cases of progressive disease. The total effective rate was 65.2% and the one year survival rate was 52.2%. There was no significant difference in the total effective rate between C-RFA plus chemotherapy group and 3D-CRT plus chemotherapy group (P >0.05), but one year survival rate of C-RFA plus chemotherapy group was higher than that of 3D-CRT plus chemotherapy group (P <0.05). The difference between the activity of NKc and the ratio of T cell subgroups was significant before and after C-RFA therapy (P <0.05). Conclusions: The C-RFA combined with chemotherapy has a definite effects on advanced NSCLC. It might be used as one of the multidisciplinary therapies for NSCLC.