| Objective:The main purpose of this study was to observe the short-term efficacy evaluation(CR,PR,SD,PD,DCR,ORR)and survival status(PFS,OS,postoperative survival,Survival rate).The secondary purpose is to observe the safety of surgery and the prevention of complications,and to provide a reference for the clinical application of argon-helium knife in non-small cell lung cancer.Methods:Observed 35 patients with advanced non-small cell lung cancer who were treated with argon-helium knife in the oncology department of our hospital between November 1,2013 and April 30,2019.All the included patients were followed up,and the names,gender,age,pathological type,degree of differentiation,EGFR gene status,tumor TNM stage,survival data,and treatment status of traditional Chinese and Western medicine before and after surgery were recorded.The mRECIST solid tumor curative effect evaluation standard was used for short-term imaging evaluation after argon-helium knife surgery.Use Excel to establish a database and store the data,and use SPSS 25.0 software to statistically analyze and study the data.P<0.05 is considered statistically significant.Results:1.Imaging evaluation of recent curative effect:35 patients with advanced NSCLC received a total of 37 argon and helium knife cryoablations(two patients did twice),and a total of 37 radiographic evaluations of recent efficacy were performed in January:CR(0/37),PR(34/37),SD(2/37),PD(1/37),the objective effective rate of disease was 91.89%(34/37),and the disease control rate was 97.30%(36/37).2.Progression-free survival(PFS):The median progression-free survival(mPFS)of 35 patients was 6.54 months.According to the treatment method after argon-helium knife treatment,17 patients were treated with traditional Chinese medicine after argon-helium knife treatment,with mPFS of 4.17 months;18 patients were treated with integrated Chinese and Western medicine after the operation,and mPFS was 8.44 months,And the P-0.05 of Log-Rank test has statistical difference.Among patients treated with integrated Chinese and Western medicine after surgery,mPFS was 9.00 months in 9 patients combined with chemotherapy based on Chinese medicine,mPFS was 9.73 months in 3 patients combined with radiotherapy and chemotherapy,and mPFS was 9.27 in 2 patients targeted therapy Months(targeted drugs are octinib,afatinib),radiotherapy and chemotherapy+targeted therapy 1 patient's PFS is 8.10 months(targeted drug is gefitinib),chemotherapy+anti-angiogenesis therapy The mPFS of 2 patients was 9.07 months,and the PFS of one patient with chemotherapy+anti-blood and anti-angiogenesis therapy+DC-CIK and other cell immune reinfusion therapy was 14.03 months.3.Overall survival,postoperative survival and survival rate:3.1 Overall survival,postoperative survival and survival rate of all patients:As of the follow-up date,32 of 35 patients died and 3 survived(recorded as deleted)Lost).The median survival time(mOS)of all patients was 22.37 months;the 6-month,1-year,2-year,3-year survival rates,and 5-year survival rates were 82.86%,73.53%,37.5%,18.75%,and 0%,respectively.The survival time of all patients after argon-helium knife surgery was 7.77 months;the survival rates of 6 months,1 year,2 years,3 years,and 5 years after argon-helium knife surgery were 71.43%,32.35%,9.38%,and 3.13%,0%,respectively.3.2 Postoperative survival and survival rate of the postoperative Chinese medicine treatment group and the postoperative integrated Chinese and Western medicine treatment group:In this study,there were 17 people in the traditional Chinese medicine treatment group after argon-helium knife surgery,and the postoperative survival period was 6.30 months.There were 18 people in the treatment group,the postoperative survival time was 11.87 months,and the P-0.05 of the Log-Rank test was statistically different.The 6-month,1-year,2-year,3-year,and 5-year survival rates of the Chinese medicine treatment group after argon-helium knife surgery were 58.82%,17.65%,5.88%,0%,and 0%,respectively.The postoperative 6-month,1-year,2-year,3-year,and 5-year survival rates of the combined Chinese and Western medicine treatment group were 83.33%,47.06%,13.33%,6.67%,and 0%,respectively4.Intraoperative and postoperative complications and treatment and outcomes:In 37 times of argon-helium knife cryoablation,common intraoperative complications include intraoperative pain in 3 cases(need immediate pain relief,otherwise it will affect the operation).There were 2 cases of sputum(hemorrhagia)blood during operation and 5 cases of pneumothorax during operation,which were alleviated by symptomatic treatment by Western medicine,and none of them affected the completion of the operation.The complications after argon-helium knife surgery included 11 cases of postoperative pain,11 cases of phlegm and blood after the operation,9 cases of postoperative fever,4 cases of postoperative pleural effusion,and 1 case of postoperative pneumothorax.Both reduced and symptomatic treatment by Western medicine can be relieved.5.The number of freezing cycles,the average freezing time,and the rewarming time:35 patients undergoing cryoablation performed a total of 37 freeze ablation,2 times 3 freeze cycles,34 times 2 freeze cycles,1 time 1 freezing cycle;the average freezing time of all patients was 27.16 min,and the average rewarming time was 8.71 minConclusion:For patients with advanced non-small cell lung cancer who are negative for driver genes,the sooner they may receive argon-helium cryoablation,the better the prognosis.Conversely,patients with relatively poor prognosis undergoing cryoablation with argon and helium may not benefit much in terms of survival.In the treatment of advanced non-small cell lung cancer patients with negative driver genes,argon-helium knife cold ablation is better than simply receiving traditional Chinese medicine after surgery.The argon-helium knife cryoablation combined with other treatments based on traditional Chinese medicine has a good long-term disease control rate,has the characteristics of less trauma and the lighter economic burden,and is worth clinical promotion. |
PDF Full Text Request