Umdlavuza wamaphaphu ungenye yezimbangela ezivame kakhulu zokufa kwabantu ngenxa yamathumba, futhi izinga lokugula nokufa kwawo kukleliswe kuqala emadolobheni. I-pathology ikakhulukazi umdlavuza wamaphaphu ongewona omncane (NSCLC), obalwa cishe ngama-85%. Iziguli eziningi zisesigabeni esimaphakathi nesemuva lapho zixilongwa, futhi u-60 kuya ku-80% weziguli ezinomdlavuza wamaphaphu ziye zalahlekelwa ithuba lokuhlinzwa lapho zitholakala nakanjani. Ngesikhathi esifanayo, iphaphu liyisitho sesibili esimetastatic kalula kakhulu sezimila eziqinile, lilandelwa ama-metastases esibindi. Ukwelashwa kokuhlinzwa kuvame ukusetshenziselwa iziguli ezinenani elilinganiselwe nelilinganiselwe lama-metastases. Ukuhlinzwa kudinga ukususwa kwengxenye yezicubu zamaphaphu ngomsebenzi ojwayelekile. Ngakho-ke, izindlela ezintsha zokwelapha nazo ziyadingeka ukuze kubuyiselwe ukuhlinzwa.
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 umdlavuza wamaphaphu.
Kuyini ukukhishwa kwefrikhwensi yomsakazo?
Radiofrequency ablation consists of an electrode needle inserted into the isisu 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.
Yimuphi umdlavuza wamaphaphu i-RFA esebenza kuwo?
1. Used for umdlavuza wamaphaphu weselula ongewona omncane 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 umdlavuza webele 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. Isiguli, owesifazane, oneminyaka engu-48 ubudala, one-metastasis yephaphu elilodwa ngemva kokuhlinzwa komdlavuza webele. Ukwelashwa kweziguli ezinomdlavuza wamaphaphu ongewona omncane omncane, okuhlanganisa i-tyrosine kinase inhibitors (TKI), njenge-Kemena, i-Iressa noma i-Trocaine ngemuva kokumelana nezidakamizwa zendawo. Isibonelo, ukwelashwa kwe-TKI sekuphenduke inketho yokwelashwa yomugqa wokuqala ezigulini ezinezinguquko ezibucayi ze-epidermal growth factor receptor (EGFR) kumdlavuza wamaphaphu ongewona omncane omncane. Isikhungo Sokucwaninga Ngomdlavuza Wesibhedlela i-Shao Yifu sisebenzisa ubuchwepheshe be-RFA ekwelapheni umdlavuza wamaphaphu ongewona omncane kanye nenye yezindlela zokwelapha ezihlukile zokunqoba ukumelana ne-TKI.
4: Owesifazane oneminyaka engu-59 ubudala onomdlavuza wamaphaphu ongewona omncane (ukuguqulwa kwe-EGFR) ne-intra-pulmonary metastasis, izinyanga ezingu-15 ngemva kokwelashwa kwe-TKI yomlomo, isimila samaphaphu esingezansi kwesokudla (Umfanekiso B) sisobala kakhulu kunangaphambili (Umfanekiso A) njengoba kuboniswe umcibisholo Ukwanda, ukuqhubeka kwesifo; Ukwelashwa kwe-RFA eqondiswa yi-CT yesimila samaphaphu esingakwesokudla esingezansi (Umfanekiso C), kulandelwe izinyanga ze-3 (Umfanekiso D), izinyanga ezingu-6 (Umfanekiso E) ubonise ukulawula okuhle.
4. Kuhlanganiswe ne-chemotherapy kanye ne-radiotherapy. I-Chemotherapy kanye ne-radiotherapy ehlanganiswe ne-radiofrequency ablation therapy isetshenziselwa i-metastatic tumors yesibindi namaphaphu. Ukusetshenziswa okuhlangene kwakho kokubili kungavala ukushiyeka kwazo futhi kuthuthukise ukusebenza kahle. Uma kuqhathaniswa nanoma iyiphi imodi yokwelapha eyodwa, yelula isikhathi sokusinda kwesiguli futhi ithuthukise izinga lempilo.
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: Isiguli esinomdlavuza wamaphaphu esineminyaka engu-88 siphinde sahlaselwa yi-intra-pulmonary and pleural metastasis (ekhonjiswe kuMidwebo A no-B). Ubuhlungu obukhulu kunzima ukulala. Ubuhlungu besiguli badamba kakhulu ngemva kokwelashwa kwe-RFA kwezimila zamaphaphu, futhi izinga lokulala laba ngcono kakhulu. Ngemva konyaka wokulandelela, isiguli ngokuvamile sasisesimweni esihle sinezimila zamaphaphu ezinzile.
