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Zhikai Z.,Jinan University | Lizhi N.,Jinan University | Lizhi N.,Fuda Institute of Lung Cancer | Liang Z.,Jinan University | And 10 more authors.
Cryobiology | Year: 2013

Most patients with central type lung cancer (CTLC) are not candidates for surgery; systemic chemotherapy and external beam radiotherapy are the main treatments but have not greatly affected patient outcome. Combined percutaneous and endobronchial cryotherapy has been used successfully to treat CTLC; this study aimed to determine its feasibility and safety. Forty-seven patients with unresectable CTLC (22 endotracheal, 26 tracheal wall and 21 extratracheal tumors) underwent 69 sessions of combined percutaneous cryosurgery, endobronchial cryosurgery and airway stenting. The long diameter of all tumors was <5. cm. Biopsy showed non-small cell lung cancer (NSCLC) in 40 patients (medium or well differentiated in 20 cases, poorly differentiated in 20) and small cell lung cancer (SCLC) in seven. Within 3. days after treatment, ventilatory capacity and performance status had obviously increased and cough, signs of dyspnea, hemoptysis and atelectasis improved significantly, but symptoms of pneumothorax and pleural effusion emerged. After 2. weeks, all complications had disappeared completely, as had cough. Progression-free survival (PFS) for endotracheal tumors (8. ±. 4. months) was shorter than that for tracheal wall (13. ±. 6. months, P<. 0.05) and extratracheal (14. ±. 8. months, P<. 0.01) tumors. The PFS of NSCLC (11. ±. 5. months) was significantly longer than that of SCLC (4. ±. 2. months, P<. 0.0001). The PFS of medium or well differentiated CTLC (15. ±. 8. months) was significantly longer than that of poorly differentiated CTLC (7. ±. 3. months, P<. 0.0001). In conclusion, combined cryotherapy is a safe and effective treatment for CTLC, with PFS largely influenced by tumor location and pathologic type. © 2013 Elsevier Inc. Source


Mu F.,Chinese Academy of Sciences | Niu L.,Jinan University | Niu L.,Fuda Institute of Cryosurgery for Cancer | Li H.,Chinese Academy of Sciences | And 11 more authors.
Cryobiology | Year: 2013

Percutaneous ablation is the currently preferred locoregional therapy for non-resectable hepatocellular cancer (HCC). Cryoablation is an attractive option because it forms an ice ball viewable by many imaging methods. This study assessed the therapeutic effect of comprehensive cryoablation (of intra- and extrahepatic tumors) in patients with metastatic HCC. Forty-five patients met the inclusion criteria from January, 2004 to October, 2011. Treatment was performed on 33 patients; 12 patients received no treatment. Procedural safety and overall survival (OS) were assessed according to metastatic stage. The OS of patients who received comprehensive treatment was significantly longer than that of those who received no treatment (median: 26 vs. 3.5. months, P<. 0.001). Large (5. cm long diameter) hepatic tumors were treated in advance with transarterial chemoembolization, but the OS of patients in the same metastatic stage was similar (. P=. 0.0677). In the comprehensive cryoablation group, timely treatment (within 2. months after diagnosis of metastatic HCC) was associated with a longer OS than when treatment was delayed for 3-7. months (median: 38.5 vs. 21. months, P=. 0.0167). Multiple treatments improved the survival of patients who received comprehensive treatment (. P=. 0.0489). In terms of increasing the survival time of metastatic HCC patients, the effect of comprehensive cryosurgery was significant. Timely or multiple treatments had greater therapeutic effects than delayed or single treatment. © 2012 Elsevier Inc. Source


Shi J.,Jinan University | Niu L.,Jinan University | Niu L.,Fuda Institute of Cryosurgery for Cancer | Huang Z.,Jinan University | And 7 more authors.
Cryobiology | Year: 2013

Coagulopathy after liver cryoablation was first reported many years ago; the cause is local platelet trapping and destruction within the margin of the cryolesion. However, the prognosis and therapeutic effects of coagulopathy remain unclear. This study retrospectively reviewed clinical data from 372 patients (525 sessions) who underwent liver cryoablation in our hospital during the past 4.5years. Small tumors (major diameter<6cm) were treated with a single complete ablation; massive tumors (major diameter 6-10cm or >10cm) were divided into two or three parts that were dealt with in turn. Platelet counts decreased to an average of (46.12±68.13)×109/L after each session of cryoablation. The decline was most evident in patients with high pretreatment platelet counts, while those with low pretreatment counts had the highest risk of coagulopathy. Change in platelet count was not correlated with the diameter of the tumor. Slight coagulopathy (platelet count (70-100)×109/L) can resolve without treatment within 1week and administration of recombinant human interleukin-11 can assist recovery from severe coagulopathy (platelet count<70×109/L). © 2013 Elsevier Inc. Source


Niu L.,Jinan University | Niu L.,Fuda Institute of Cryosurgery for Cancer | Li J.,Jinan University | Zeng J.,Jinan University | And 7 more authors.
Cryobiology | Year: 2014

We compared imaging and pathological changes between argon-helium cryosurgical (AH) and microwave (MW) ablation in a porcine liver model. Immediately after ablation, computed tomography (CT) imaging showed that the area affected by MW ablation was considerably greater than that affected by AH ablation; moreover, the surface area of necrotic tissue was considerably greater in the AH group, whereas the depth of the necrotic area was similar. Seven days after ablation, the affected area had not changed much in the AH group, but it had significantly increased in the MW group; similarly, the surface and depth of the necrotic areas had not changed much in the AH group, but they had increased significantly in the MW group. The pathological findings showed similar definitive areas for both groups at both time points. The findings indicated that long time after both therapies, complete tissue necrosis can be achieved, but the extent and depth of necrosis differ: necrosis foci after AH ablation could be predicted by ice ball under CT image, and necrosis foci after MW ablation will increase obviously. MW ablation might therefore be suitable for tumors with a larger volume and simple anatomical structures, and AH ablation might be suitable for tumors with complex anatomical structures or those located near important organs. These two methods could therefore be used in combination in clinical settings, but details of the procedure need to be studied. © 2014 Elsevier Inc. Source


Niu L.,Jinan University | Niu L.,Fuda Institute of Cryosurgery for Cancer | Chen J.,Jinan University | Yao F.,Jinan University | And 17 more authors.
Cryobiology | Year: 2013

The aim of this study was to investigate the therapeutic effect of cryoablation treatment and palliative treatment in stage IV lung cancer. Fifty-four patients were enrolled into the study. Thirty-one patients received cryoablation treatment (including intra- and extrapulmonary tumors), and 23 patients had palliative treatment (no cryoablation). Both the safety of the procedure and overall survival (OS) for stage IV lung cancer were assessed during a 6.5. year follow-up period. The OS of patients in both groups and the effects of treatment timing and frequency were compared. The OS in the cryoablation group was significantly longer than in the palliative group (median OS: 14. months vs. 7. months, P= 0.0009). The OS of those who received delayed cryoablation treatment was longer than that observed for those who received timely treatment (median OS: 18.5. months vs. 10. months, P= 0.0485), but this was not observed in those who received palliative treatment (median OS: 7. months vs. 7.5. months, P= 0.9814). Multiple treatments played an important role in improving the OS of patients who received cryoablation treatment (median OS: 18. months vs. 14. months, P= 0.0376). There was a significant difference between cryoablation and palliative treatment, in terms of OS. In addition, multiple cryoablation treatments may have an advantage over single treatments. © 2013 Elsevier Inc. Source

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