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目的 :观察在CT引导下射频消融 (RFA )结合健择 +顺铂治疗周围型非小细胞肺癌 (NSCLC )的短期疗效和安全性。方法 :选择临床分期为Ⅲb ,Ⅳ期周围型NSCLC病人 14例 ,给予健择 +顺铂化疗 ,随后在CT引导下行经皮RFA ,完成 3周期化疗后CT平扫和增强扫描评价疗效 ,观察RFA术中术后并发症。结果 :14例病人完成化疗和RFA ;化疗第 3周期完成后肿瘤体积明显缩小 ,总有效率 (CR +PR) 85 .7% ,肿瘤组织密度均有显著降低 ,表现为凝固性坏死和去血管征象 ;并发症包括局限性气胸 2例 ,术后少量咯血 3例 ,术后发热 11例。结论 :RFA结合健择 +顺铂化疗治疗Ⅲb、Ⅳ期周围型肺癌的短期疗效非常显著 ,并发症发生率低 ,安全性高。
Objective: To observe the short-term efficacy and safety of CT-guided radiofrequency ablation (RFA) combined with gemcitabine and cisplatin in the treatment of peripheral non-small cell lung cancer (NSCLC). Methods: Fourteen patients with stage Ⅲb and Ⅳ NSCLC were enrolled in this study. The patients were treated with gemcitabine and cisplatin. Percutaneous RFA was performed under the guidance of CT. The CT scan and enhanced scan after 3 cycles of chemotherapy were performed to evaluate the efficacy of RFA Intraoperative and postoperative complications. Results: Chemotherapy and RFA were completed in 14 patients. After the third cycle of chemotherapy, the tumor volume was significantly reduced. The total effective rate (CR + PR) was 85.7%. The tumor tissue density was significantly decreased, showing coagulation necrosis and degranulation The complications included 2 cases of limited pneumothorax, 3 cases of postoperative hemoptysis and 11 cases of postoperative fever. Conclusion: The short-term curative effect of RFA combined with gemcitabine and cisplatin chemotherapy in stage Ⅲb and Ⅳ of peripheral lung cancer is very significant, the complication rate is low and the safety is high.