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目的:探讨氩氦刀联合放疗一线治疗晚期EGFR野生型非小细胞肺癌合并慢性阻塞性肺疾病(COPD)患者的近期疗效。方法:对26例EGFR野生型合并COPD的肺癌患者在一线化疗的基础上对胸部不同部位病灶合理利用放疗和氩氦刀联合治疗。对中央病灶或纵隔转移淋巴结实行姑息性三维适行放疗(3DCRT),而对周围肺部病灶行经皮穿刺氩氦刀冷冻消融治疗,观察其近期治疗效果和不良反应。结果:26例患者经过联合治疗后,一线有效率达到42.31%,疾病控制率(DCR)为80.77%,近期疗效并不弱于PS评分好的晚期肺癌患者。所有患者的不良反应均为Ⅰ到Ⅱ级,经处理后都能完成整个治疗过程。结论:对于晚期EGFR野生型非小细胞肺癌合并慢性阻塞性肺疾病患者,设计个体化方案,通过合理利用化疗、放疗、氩氦刀能取得较好的疗效。
Objective: To investigate the short-term curative effect of first-line Argon-Helium Knife combined with radiotherapy in the treatment of advanced non-small cell lung cancer with EGFR and chronic obstructive pulmonary disease (COPD). Methods: Twenty-six cases of lung cancer with EGFR wild-type and COPD were treated with radiotherapy and argon-helium combined therapy on the basis of first-line chemotherapy. The central lesion or mediastinal lymph node dissection palliative three-dimensional adaptive radiotherapy (3DCRT), while the surrounding lung lesions percutaneous puncture and cryogenic ablation of argon-helium knife to observe the short-term treatment and adverse reactions. Results: After the combination therapy, the effective rate of first line and the rate of disease control (DCR) were 42.31% and 80.77%, respectively. The short-term efficacy was not weaker than that of advanced lung cancer with PS score. All patients with adverse reactions are Ⅰ to Ⅱ level, after treatment can complete the entire course of treatment. CONCLUSIONS: Individualized regimens for patients with advanced EGFR wild-type NSCLC with chronic obstructive pulmonary disease are designed to achieve better outcomes by rational use of chemotherapy, radiotherapy, and argon-helium cryoablation.