Chemotherapy Combined With CT Guided Percutaneous Microwave Coagulation Therapy In The Treatment Of Advanced Non-small Cell Lung Cancer

Background and Objective:In these years,the morbidity and mortality rate of lung cancer had the obvioustrend of escalation in our country. The statistics Released by Ministry of Health in2012showed that the mortality ratio of lung cancer was30.83（1/10-5），representedthe leading cause of death from malignant tumors in the world. Currently, surgicalexcision still is the first choice for treatment of primary bronchogenic carcinoma.Because of the low level of early diagnose,the complicated biological features andthe high level of malignancy，80%of lung cancer patients diagnosed at anintermediate or late stage，lost the opportunities of radical surgery. Only15%ofpatients had the indications for curative resection.The comprehensive treatment ofadvanced non-small cell lung cancer included chemotherapy, radiation therapy,molecular targeted therapy, etc. In recent years,microwave ablation was graduallyused for the treatment of advanced lung cancer,In this paper, the purpose of study wasto evaluate the clinical value of treatment of advanced non-small cell lung cancer onCT guided percutaneous microwave coagulation therapy combined with chemother-apy treatment.Methods:67cases of hospitalized patients of the First Affiliated Hospital of NanchangUniversity in September1,2012~September31,2013were analyzed retrospectively.the main symptoms of these patients were cough, sputum, chest pain, hemoptysis,chest tightness, etc.all these patients were diagnosed as non-small cell lung cancer（Ⅲ b～Ⅳperiod）by clinical imaging and pathological examination.33cases used pure chemotherapy (control group), chemotherapy regimens for:squamous carcinoma: GP regimen:(gemcitabine+cisplatin) or DP regimen:(docetaxel+cisplatin); Adenocarcinoma: PP regimen:(pemetrexed+cisplatin) orDP regimen (docetaxel+cisplatin), while34cases combined Microwave ablationunder CT guided with chemotherapy (experimental group).The Chemotherapy regimens as well as the control group;1,3,6months after treatment, the curative effectwere evaluated according to review the chest CT measurement tumor volumesize,.And the two groups of patients were followed-up for a long time and theprogression-free survival time(PFS) and occurrence of side effects were statisticallyobserved.Result：1.Treatment and side effects:all patients were successfully completed microwaveablation and chemotherapy, no serious complications occurred during the CT-guidedmicrowave ablation of lung cancer. There were6cases of penumothorax（17.65%）inthe experimental group，the occurrence rate of penumothorax was higher than thecontrol group and the difference had statistical significance(P＜0.05).Experimentalgroup had higher incidence of sputum blood than the control group,the difference hadstatistical significance(2＝6.031， P＜0.05).The occurrence rate of generalcomplication such as fever, chest pain and bone marrow suppression betweenexperimental group and control group had no statistically significant difference.2.short term effect:the control group (33cases): complete response (CR)0cases(0.00%), partial response (PR) in12cases (36.36%), the total effective rate (CR+PR) was36.36%. Experimental group (34cases): complete remission (CR),8cases(23.53%), partial response (PR)16cases (47.06%), the total effective rate (CR+PR)was70.59%. Experimental group showed a statistically higher total effective ratecompared with control group（2＝7.890，P＜0.01）.3.KPS: KPS of experimentalgroup at1and3months after surgery were81.76±7.16and78.82±6.4respectively;KPS of control group at1and3months after surgery were72.72±4.52and73.03±4.67respectively;Experimental group had a statistically higher KPS comparedwith control group （P＜0.05）.4. progression-free survival (PFS): the medianprogression-free survival (PFS) time of control group and experimental group were3.6±0.2months and5.4±0.1months respectively. There were significant differencesin statistics between the two groups（2＝42.731，P＜0.01）.Conclusion：1.CT-guided percutaneous microwave ablation was a new kind of method inadvanced NSCLC treatment with features such as easy operation,minimal trauma,high-security,generally good toleration and less adverse reactions.2.Microwave ablation combined with chemotherapy had cooperation in treatment ofadvanced NSCLC,can significantly killing the tumor cells in a short time. showedbetter results in improving the local control rate and the quality of life,prolongingprogression-free survival (PFS) than chemotherapy alone.It is Worth of furtherpromoting application in the future clinical work.