O'pka saratoni o'smalar tufayli inson o'limining eng keng tarqalgan sabablaridan biri bo'lib, uning kasallanish va o'lim darajasi shaharlarda birinchi o'rinda turadi. Patologiya asosan kichik hujayrali bo'lmagan o'pka saratoni (NSCLC) bo'lib, taxminan 85% ni tashkil qiladi. Ko'pgina bemorlar tashxis qo'yilganda o'rta va kech bosqichlarda bo'ladi va o'pka saratoni bilan og'rigan bemorlarning 60-80 foizi aniq tashxis qo'yilganda operatsiya qilish imkoniyatini yo'qotadi. Shu bilan birga, o'pka qattiq o'smalarning ikkinchi eng oson metastatik organidir, keyin esa jigar metastazlari. Jarrohlik davolash ko'pincha cheklangan va cheklangan miqdordagi metastazlar bo'lgan bemorlar uchun qo'llaniladi. Jarrohlik normal faoliyat ko'rsatadigan o'pka to'qimalarining bir qismini olib tashlashni talab qiladi. Shuning uchun operatsiyani almashtirish uchun yangi davolash usullari ham talab qilinadi.
In recent years, the minimally invasive radiofrequency ablation (RFA) technology has been used more and more as a minimally invasive treatment method in the treatment of primary / secondary lung tumors, and has made great progress, known as the treatment “Dinghaishen Needle” for o'pka saratoni.
Radiochastota ablasyonu nima?
Radiofrequency ablation consists of an electrode needle inserted into the shish tissue and an electrode plate attached to the patient’s body to form a current loop. After the RF generator is turned on, high-frequency alternating current at the electrode tip is injected into the target tissue (Figure 2A), causing ions in the tissue to occur Shock, friction and heat generation will follow, causing cell death and coagulation necrosis in the target tissue around the electrode (Figure 2B). At the same time, the vascular tissue around the tumor will coagulate to form a reaction zone, preventing it from continuing to supply blood to the tumor and preventing tumor metastasis. Radio frequency waves can also cause tumor blood vessels to coagulate and reduce blood supply. At the same time, the ablated tumor tissue remains in the body. Due to its composition and structural changes, it can stimulate the body’s immunity and produce anti-tumor cytotoxic antibodies, and induce cytotoxic T cell immunity.
RFA qaysi o'pka saratoni uchun qo'llaniladi?
1. uchun ishlatiladi kichik hujayrali o'pka saratoni that cannot tolerate surgery. Tumor diameter ≤2cm, 78 ~ 96% of patients can achieve complete ablation; tumor diameter ≤3cm, 5-year survival rate exceeds 50%. The treatment effect is better for primary lung cancer with a diameter ≤5cm.
2. For the treatment of lung metastases. Studies have shown that lung metastases with a diameter ≤2-3 cm, patients with lung metastases receiving RFA treatment have a 3-year survival rate of 53.7% and a 4-year survival rate of 44.1%. As shown in Figure 3, a ko'krak saratoni patient relapsed with a single left lung metastasis. After RFA treatment, the follow-up and follow-up for nearly 3 years showed a good quality of life and no distant recurrence.
3. Bemor, ayol, 48 yosh, ko'krak bezi saratoni operatsiyasidan keyin bitta o'pkada metastaz bilan. Kengaytirilgan kichik hujayrali o'pka saratoni bilan og'rigan bemorlarni davolash uchun, shu jumladan tirozin kinaz inhibitörleri (TKI), masalan, Kemena, Iressa yoki Trokain mahalliy dori qarshiligidan keyin. Masalan, TKI terapiyasi rivojlangan kichik hujayrali o'pka saratonida rivojlangan epidermal o'sish omili retseptorlari (EGFR) sezgir mutatsiyalari bo'lgan bemorlar uchun birinchi darajali davolash variantiga aylandi. Shao Yifu kasalxonasi saraton tadqiqot markazi kichik hujayrali bo'lmagan o'pka saratonini palliativ davolash uchun RFA texnologiyasidan foydalanadi va TKI qarshiligini engish uchun muqobil davolash usullaridan biri hisoblanadi.
4: O'pka ichidagi metastazli kichik hujayrali bo'lmagan o'pka saratoni (EGFR mutatsiyasi) bilan og'rigan 59 yoshli ayol, og'iz orqali TKI davolashdan 15 oy o'tgach, pastki o'ng o'pka shishi (B-rasm) oldingisiga qaraganda aniqroq. (A-rasm) o'q bilan ko'rsatilganidek, kasallikning kuchayishi, rivojlanishi; Pastki o'ng o'pka o'simtasini KT bo'yicha RFA davolash (rasm C), 3 oy davomida kuzatilgan (D-rasm), 6 oy (E-rasm) yaxshi nazoratni ko'rsatdi.
4. Kimyoterapiya va radioterapiya bilan birgalikda. Metastatik jigar va o'pka shishi uchun radiochastota ablasyon terapiyasi bilan birgalikda kimyoterapiya va radioterapiya qo'llaniladi. Ikkalasini birgalikda qo'llash ularning tegishli kamchiliklarini to'ldirishi va samaradorlikni oshirishi mumkin. Har qanday yagona davolash rejimi bilan solishtirganda, u bemorning yashash vaqtini uzaytiradi va hayot sifatini yaxshilaydi.
The patient, a 58-year-old male, has colon cancer with multiple liver and lung metastases in the distance, making it difficult to operate and treat. Combined with chemotherapy and targeted drug therapy, especially combined with minimally invasive radiofrequency ablation technology, it successfully cured liver and lung metastases.
5. RFA can also be used for palliative treatment to relieve various discomfort symptoms of patients with advanced lung cancer.
6: 88 yoshli keksa o'pka saratoni bilan og'rigan bemor o'pka ichidagi va plevra metastazlari bilan qaytdi (A va B rasmlarda ko'rsatilgan). Qattiq og'riq uxlab qolish qiyin. O'pka o'smalarini RFA davolashdan so'ng bemorning og'rig'i sezilarli darajada engillashdi va uyqu sifati sezilarli darajada yaxshilandi. Bir yillik kuzatuvdan so'ng, bemor odatda barqaror o'pka shishi bilan yaxshi holatda edi.
