Abstract【Objective】To investigate the efficacy of CT-guided percutaneous microwave ablation combined with chemotherapy in the treatment of EGFR-TKIs-resistant non-small cell lung cancer (NSCLC). 【Methods】A total of 89 patients with NSCLC who were admitted to our hospital were recruited in the study. According to different treatment methods after NSCLC became EGFR-TKI drug resistance, patients were divided into two groups: the microwave ablation group (n=48) and the chemotherapy group (n=41). The efficacy and safety of the two groups of patients were compared. Factors associated with progression-free survival (PFS) and overall survival (OS) of NSCLC patients were analyzed. 【Results】The objective response rate of treatment in the microwave ablation group was 93.75% (45/48), which was higher than that in the chemotherapy group [78.05% (32/41)]. The difference was statistically significant (P<0.05). Both groups of patients had different degrees of adverse reactions, and the symptoms were improved after symptomatic treatment. The average PFS of the microwave ablation group was 16.94 months, which was higher than that of the chemotherapy group 14.42 months (P<0.05). The average OS of patients in the microwave ablation group was 20.19 months, which was higher than the average OS of the chemotherapy group 19.66 months, (P<0.05).The results of Cox univariate and multivariate analysis showed that PFS and OS were poor in NSCLC patients with stage Ⅲ-Ⅳ stage, lymph node metastasis and tumor diameter >3 cm. 【Conclusion】For patients with EGFR-TKIs-resistant NSCLC, microwave ablation combined with chemotherapy can effectively control the tumor progress and improve the prognosis of patients.
CHU Xiang-jian,DAI Mei-yun. Clinical Efficacy of Microwave Ablation Combined with Chemotherapy in Treatment of Non-small Cell Lung Cancer Patients with EGFR-TKIs Resistance[J]. JOURNAL OF CLINICAL RESEARCH, 2020, 37(12): 1817-1820.
[1] Sato H, Yamamoto H, Sakaguchi M, et al. Combined inhibition of MEK and PI3K pathways overcomes acquired resistance to EGFR-TKIs in non-small cell lung cancer[J].Cancer Sci,2018,109(10):3183-3196. [2] Fogli S.EGFR-TKIs in non-small-cell lung cancer: focus on clinical pharmacology and mechanisms of resistance[J].Pharmacogenomics,2018,19(8):727-740. [3] Zhou Q, Wu S, Gong N, et al. Correction: Liposomes loading sodium chloride as effective thermo-seeds for microwave ablation of hepatocellular carcinoma[J].Nanoscale,2018,10(44):20869. [4] 刘宝东,李元博,胡牧,等.射频消融在EGFR-TKIs治疗非小细胞肺癌后局部进展的初步临床应用[J].中国肺癌杂志,2016,19(12):859-863. [5] Mok TS, Wu YL, Thongprasert S, et al. Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma[J].N Engl J Med,2009,361(10):947-957. [6] Han JY, Park K, Kim SW, et al. First-SIGNAL: first-line single-agent iressa versus gemcitabine and cisplatin trial in never-smokers with adenocarcinoma of the lung[J].J Clin Oncol,2012,30(10):1122-1128. [7] Yu HA, Sima CS, Huang J, et al. Local therapy with continued EGFR tyrosine kinase inhibitor therapy as a treatment strategy in EGFR-mutant advanced lung cancers that have developed acquired resistance to EGFR tyrosine kinase inhibitors[J].J Thorac Oncol,2013,8(3):346-351. [8] Xu B, Zhou NM, Cao WT, et al. Comparative study on operative trauma between microwave ablation and surgical treatment for papillary thyroid microcarcinoma[J].World J Clin Cases,2018,6(15):936-943. [9] 姜冠潮,李晓,张康, 等.临床Ⅰ期非小细胞肺癌N1淋巴结转移的危险因素[J].中华胸心血管外科杂志,2015,31(3):161-163.
2020, Vol. 37 
