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目的评价CT引导下肺癌瘤体内直接穿刺注射基因及免疫制剂合并射频容式加热治疗肺癌的安全性和疗效。方法中晚期周围型肺癌31例,临床Ⅲ~Ⅳ期,均无手术指征。在CT导引下,经皮穿刺瘤内注射H101和IL-Ⅱ液剂,第8、29、35、57、64天再次穿刺治疗,作为1个疗程。介入治疗期间辅以体外容式射频热疗,2次/周,共12次/人。1个疗程结束后4周,观察TSGF及瘤体的影像学变化,评价近期疗效。结果近期疗效:CR 0例、PR 22例,NC 6例,PD 3例,近期有效率71%(22/31)。治疗后,TS-GF定量和阳性率均有下降,与治疗前相比,有显著统计学差异(P<0.01)。介入治疗术后4~48h,患者均有不同程度的发热,出现率100%(31/31);局部胸痛,出现率54.8%(17/31)。射频热疗中除有3人次胸背部出现脂肪硬结外,未见其他不良反应。结论CT引导下瘤内直接穿刺注射基因、免疫制剂并容式射频加热治疗不能手术的中晚期肺癌,简便易行、副作用小、近期疗效良好。
Objective To evaluate the safety and efficacy of CT-guided direct injection of lung aspiration gene and immunotherapy in combination with radio-frequency capacitive heating in lung cancer. Methods 31 cases of advanced peripheral lung cancer, clinical stage Ⅲ ~ Ⅳ, no indications for surgery. Under the CT guidance, percutaneous intratumoral injection of H101 and IL-Ⅱ liquid, 8,29,35,57,64 days again puncture treatment, as a course of treatment. Interventional radiotherapy combined with external capacitive radiotherapy, 2 times / week, a total of 12 times / person. Four weeks after the end of one course of treatment, the imaging changes of TSGF and tumor were observed to evaluate the short-term curative effect. The results of the recent curative effect: CR 0 cases, PR 22 cases, NC 6 cases, PD 3 cases, the recent efficiency of 71% (22/31). After treatment, the quantification and the positive rate of TS-GF decreased, with a significant statistical difference (P <0.01) compared with that before treatment. Interventional treatment 4 ~ 48h, patients with varying degrees of fever, the rate was 100% (31/31); local chest pain, the incidence rate of 54.8% (17/31). In addition to RF radiotherapy chest thoracodorsal adiposity, there were no other adverse reactions. Conclusion CT guided direct intratumoral injection of genes, immune agents and capacitive radiofrequency ablation in the treatment of inoperable advanced lung cancer, simple and easy, side effects, the recent good effect.