Clinical Study Of Microwave Ablation Combined With Targeted Drugs In The Treatment Of Advanced Non-Small Cell Lung Cancer

Objectives:Investigating the clinical efficacy and safety of the treatment which CT guided microwave ablation combined with oral gifitinib in patients with advanced nonsmall cell lung cancer(NSCLC)with EGFR mutation positive.Methods:All the patients with NSCLC were in the department of oncology in the affiliated Hospital of Hebei University of Engineering.The treatment and follow-up period was from September 2016 to October 2018.63 patients with non-small cell lung cancer were randomly divided into control group and ablation group.Patients in ablation group(n = 31)were treated with Gefitinib targeted therapy combined with local ablation of MWA,and patients in control group(n = 32)were treated with Gefitinib orally.Compared with the short-term effective rate and disease control rate of patients in ablation group and control group according to the RECIST.1.1 standard of solid tumor,the long-term efficacy and progression free survival time(PFS)after treatment were statistically analyzed.Gathered statistics and analyzed the postoperative complications of ablation group by the standard of Expanded Accordion ClassificationDefinition of Levels of Severity.The quality of life(QOL)of the two groups was also evaluated according to the Zubrod-ECOG-WHO 5 score method.Then analyzed the adverse reactions of two groups using the National Cancer Institute's Common toxicity Standard version 3.0.Results: The short-term curative efficacy of MWA combined with Gefitinib group was higher than that of oral Gefitinib group;The efficacy rate(Ablation group 67.7%VS.Control group 31.3%).Disease control rate(Ablation group 87.1% VS.Control group 65.6%).The progression-free survival time and long-term effect of the ablation group were significantly higher than that of the control group,the PFS(Ablation group16.42 ± 5.49 months(95% CI: 14.4063-18.4324 months)VS.Control group 12.06 ±5.81 months(95% CI: 9.9683-14.1567 months),and the one-year survival rate was(Control group 46.9% VS.Ablation group 80.6%),two-years survival rate(Control group 21.9% VS.Ablation group 48.4%);The difference was statistically significant(P<0.05).Pneumothorax,hemorrhage,hemoptysis,pain and other complications were common in the ablation group after MWA,but most of them were grade 1 and grade 2.The quality of life in the ablation group was significantly improved than that in thecontrol group,and the difference was statistically significant(P<0.05).In the ablation group and the control group,there were rash,diarrhea,nausea and other adverse reactions,but the incidence was basically the same,the difference was not statistically significant(P>0.05).Conclusions:(1)The patients with advanced EGFR positive NSCLC benefited from MWA combined with Gefitinib,which significantly prolonging PFS,improving shortterm and long-term outcome and quality of life in patients.(2)There are some complications in the treatment of MWA,and most of the patients can tolerate it.(3)MWA combined with Gefitinib does not increase the side effects of advanced NSCLC.