Analysis Of Clinical Efficacy And Prognostic Factors Of Argon-Helium Cryoablation In The Treatment Of Middle And Late Stage Non-Small Cell Lung Cancer

Objective:This study intends to evaluate the efficacy and safety of argon-helium cryoablation targeted therapy for advanced non-small cell lung cancer(NSCLC)under CT,and to explore the related factors affecting the prognosis of patients with advanced non-small cell lung cancer(NSCLC)treated by argon-helium cryoablation.Finally,it is committed to providing more scientific basis and clinical guidance for optimizing argon-helium cryoablation in the treatment of advanced non-small cell lung cancer(NSCLC).Methods:Forty-one patients with non-small cell lung cancer who received argon-helium cryoablation in the Department of minimally invasive Interventional Therapy of the affiliated people’s Hospital of Inner Mongolia Medical University from January 2019 to December 2020 were analyzed retrospectively.The maximum tumor diameter,CT value of ablation area,KPS score and CEA and CYFRA21-1 in tumor markers were measured before,1 month and 3 months after cryoablation.In addition,the short-term effect after operation was evaluated.In the meanwhile,the complications during and after treatment were observed and summarized,and the safety was evaluated.The preoperative clinical data of the patients were recorded:age,sex,smoking history,preoperative maximum tumor diameter,pathological type,KPS score,anatomical location,degree of differentiation,tumor TNM stage and lesion location.Significant factors were obtained after univariate analysis.Besides,Logistics multivariate analysis was used to analyze the correlation between the above factors and the prognosis of the patients.Results:All patients completed the operation successfully and the process was smooth.1.There were 0 cases of complete remission of(CR),18 cases of partial remission of(PR),17cases of stable(SD)and 6 cases of progressive(PD)one month after operation.The objective effective rate was 43.90%,and the disease control rate(DCR)was 85.37%.There were 1 case of complete remission of(CR),22 cases of partial remission of(PR),11 cases of stable(SD),and 7 cases of progressive(PD)three months after operation.The objective effective rate(ORR)was 56.10%,and the disease control rate(DCR)was 82.93%.2.The preoperative enhanced CT value was(61.04±4.42)Hu,.The enhanced CT value in the ablation area was(40.47±15.38)Hu one month after operation,and(37.87±14.84)Hu 3 months after operation.The difference of CT value before operation,1 month and 3 months after operation was statistically significant(P<0.05).3.Compared with the levels of tumor markers CEA and CYFRA21-1 before treatment,the two indexes decreased in varying degrees after treatment(P<0.05).4.The KPS scores of 41 patients before treatment,1 month after treatment and 3 months after treatment were 75.61±7.43,80.73±9.33 and 83.90±9.72,respectively.The analysis showed that argon-helium cryoablation effectively improved the KPS score of the patients(P<0.05).5.A total of 7 patients had complications,with a total incidence of 17.07%,including 1 patient with intraoperative complications.It was characterized by increased heart rate and decreased blood pressure.There were 6 patients with postoperative complications,including 4 cases of pneumothorax,1 case of postoperative fever and 1 case of sputum with blood after operation.All the above patients were improved after symptomatic treatment.6.Factors affecting the prognosis of the patients:Univariate analysis showed that there were significant differences in preoperative tumor maximum diameter(X~2=8.830,P=0.003),tumor TNM stage(X~2=9.912,P=0.002),pathological type(X~2=4.120,P=0.042)and lesion location(X~2=8.830,P=0.003).Multivariate analysis by Logistics regression showed that TNM stage and the maximum diameter of tumor before operation were independent factors affecting the efficacy of argon-helium cryoablation in patients with NSCLC 3 months after operation(P<0.05).The risk of tumor progression with maximum diameter≥4cm before operation was 18.595 times higher than that with diameter<4cm.In addition,the risk of progression in stage IV was 27.797 times higher than that in stage III.Conclusions:1.Argon-helium cryoablation is effective in the treatment of advanced non-small cell lung cancer.It can not only reduce tumor load and delay disease progression,but also improve patients’quality of life and relieve patients’uncomfortable symptoms.2.Argon-helium knife for the treatment of non-small cell lung cancer is a minimally invasive operation,which has the advantages of safety and efficiency,low trauma,short postoperative recovery time and less complications.It brings good news to the patients who can not operate or can not tolerate other treatments.3.The independent prognostic factors of argon-helium cryoablation for non-small cell lung cancer were preoperative tumor maximum diameter and tumor TNM staging.The smaller the lesion diameter and the earlier the tumor stage is,the better the prognosis is.