肺癌的微创治疗
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摘要
肺癌对人类健康的危害日益严重,在多数发达国家中,肺癌的发病率和死亡率在男性常见恶性肿瘤中占首位,在女性常见恶性肿瘤中占第二位或第三位。肺癌患者就诊时绝大多数已为中晚期,能够手术治疗者仅占20%~30%,尽管目前多学科综合治疗取得一定进展,但总的治愈率和5年生存率仍低于15%。近年来,微创治疗技术已成为恶性肿瘤治疗的热点。这些微创治疗方法的应用对肺癌的治疗产生了哪些变化?是否真的微创、安全?如何合理的评价疗效?如何合理联合应用?就成为我们急需解决的问题。目前临床上常见的微创治疗技术主要分为五种:超低温冷冻消融效应,高温消融效应,放射线束损毁效应,光动力效应,介入治疗技术。本文通过对比研究临床文献中这五种微创治疗技术的安全性、临床疗效及评价方法。发现这些治疗方法并发症多不严重,且发生率低;在控制局部病灶,提高生活质量等近期疗效上效果显著,但远期疗效如何尚无定论;在评价方法上没有统一的衡量标准,且存在很多不严谨之处:例如,在统计生存率的时候未将各TNM分期分开来统计;在筛选病例时没有尽量排除众多干扰因素。本文通过对这些临床报导的分析,希望对今后如何开展微创治疗的临床研究提供一些参考和帮助。
Bronchogenic carcinoma is seriously jeopardizing people’s health day by day. In most developed country, the inception rate and mortality rate of bronchogenic carcinoma have been the first place in frequency malignant tumor of male, the second or third place of female. When the patient found they have bronchogenic carcinoma, most of them have been in middle or advanced stage. Only 20 to 30 percent people can accept operation. Although combined therapy has made much progress, the cure rate and survival rate in 5 years are still lower than 15%. In recent years, Minimally Invasive Surgical Technology have become to the focus treatment of malignant tumor. What changes do these Minimally Invasive Surgical Technology bring to lung cancer’treatment? Are they really micro-hurt and safe? How to evaluate curative effect reasonable? How to combine with other therapy rational? And so on. These questions need to be solved emergently. Minimally Invasive Surgical Technology which we often use in clinical can separated to five categories: ultra low temperature cryoablation therapy、mega temperature ablation therapy、radioactive therapy、photodynamic therapy and interventional therapy. The author contrasts and statistic the data of every clinical literature to analyze the safety、curative effect、the standard of evaluation. The conclusion is these therapies’s neopathy are not serious and the incidence rate is very lower; they can control the local lesion very good and improve the quality of patients’life. They have predominant effect in the near future, but prostecdtive efficacy is unknown. There are no unified standard on how to evaluate the effects of Minimally Invasive Surgical Technology. There are also many shortcomings in designing. Such as, some professor don’t statistics survival rate according to different TNM stages; when screening patient, they didn’t elimination interference factor, et al. Through analyzing these clinical literature, hope to benefit to future research and provide some reference help.
Bronchogenic carcinoma is seriously jeopardizing people’s health day by day. In most developed country, the inception rate and mortality rate of bronchogenic carcinoma have been the first place in frequency malignant tumor of male, the second or third place of female. When the patient found they have bronchogenic carcinoma, most of them have been in middle or advanced stage. Only 20 to 30 percent people can accept operation. Although combined therapy has made much progress, the cure rate and survival rate in 5 years are still lower than 15%. In recent years, Minimally Invasive Surgical Technology have become to the focus treatment of malignant tumor. What changes do these Minimally Invasive Surgical Technology bring to lung cancer’treatment? Are they really micro-hurt and safe? How to evaluate curative effect reasonable? How to combine with other therapy rational? And so on. These questions need to be solved emergently. Minimally Invasive Surgical Technology which we often use in clinical can separated to five categories: ultra low temperature cryoablation therapy、mega temperature ablation therapy、radioactive therapy、photodynamic therapy and interventional therapy. The author contrasts and statistic the data of every clinical literature to analyze the safety、curative effect、the standard of evaluation. The conclusion is these therapies’s neopathy are not serious and the incidence rate is very lower; they can control the local lesion very good and improve the quality of patients’life. They have predominant effect in the near future, but prostecdtive efficacy is unknown. There are no unified standard on how to evaluate the effects of Minimally Invasive Surgical Technology. There are also many shortcomings in designing. Such as, some professor don’t statistics survival rate according to different TNM stages; when screening patient, they didn’t elimination interference factor, et al. Through analyzing these clinical literature, hope to benefit to future research and provide some reference help.
引文
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