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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

Li H.,Jinan University | Li H.,Fuda Institute of Cryosurgery for Cancer | Tang K.,Jinan University | Niu L.,Jinan University | And 8 more authors.
Cancer Biomarkers | Year: 2013

Carcinoembryonic antigen (CEA) is a prognostic marker for early-stage non-small cell lung cancer (NSCLC), and cryoablation is a new therapeutic alternative for lung cancer. We determined whether cryoablation-induced changes in serum CEA levels correlated with tumor type (adenocarcinoma or squamous carcinoma) and treatment type (comprehensive therapy [cryoablation of all intra- and extrapulmonary tumors] or palliative therapy [cryoablation of only extrapulmonary tumors]) in patients with metastatic NSCLC, and assessed whether pre-treatment CEA levels predicted overall survival (OS). We retrospectively reviewed the clinical data of 88 patients with metastatic NSCLC who underwent comprehensive (62 patients) or palliative (26 patients) therapy. Pre- and post-cryoablation serum CEA levels and overall survival were determined for all patients. Cryoablation significantly reduced CEA levels in adenocarcinoma, but not squamous carcinoma, patients. Among adenocarcinoma patients, the cryoablation-induced reduction in CEA levels was significantly greater after comprehensive treatment than after palliative treatment; the OS of patients under comprehensive cryoablation was longer than those under palliative treatment. Among adenocarcinoma patients receiving comprehensive cryoablation, OS was significantly longer in those with normal pre-treatment serum CEA levels than in those with abnormal pre-treatment serum CEA levels. Pretreatment level and change of serum CEA can be a good indicator for therapeutic effects and OS in metastatic NSCLC patients under percutaneous cryosurgery. © 2013 - IOS Press and the authors. All rights reserved. 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

Zhang Z.,Jinan University | Wu B.,Jinan University | Wu B.,Fuda Institute of Cryosurgery for Cancer | Niu L.,Jinan University | And 11 more authors.
Cryobiology | Year: 2013

Thymomas are the most common tumors of the mediastinum. These tumors often compress vital mediastinal organs and severely impact the quality of life of thymoma patients. To avoid the side effects of chemoradiotherapy, some patients with unresectable malignant thymomas have opted to undergo cryotherapy in our hospital. We reviewed the cryosurgery, nursing and follow-up records of our hospital for the past 8. years, and evaluated the safety and efficiency of cryotherapy in 19 patients with unresectable malignant thymomas. No severe complications involving the vital organs surrounding the tumor occurred during or after cryosurgery. The most common side effect was pleural effusion, which occurred in 11 patients and healed after drainage within 1. week. Cough, mediastinal and pericardial effusions, pneumothorax, mild fever and chest tightness also occurred and resolved 1. week after symptomatic treatment. Since our patients had high KPS scores and mild myasthenia gravis symptoms before the treatment, myasthenia gravis did not occur after the treatment. The progression-free survival of the patients was 14-29. months (median, 18. months), and did not differ between patients with large tumors and those with small tumors (P= 0.6753). In conclusion, cryotherapy is a safe and efficient method for the treatment of unresectable malignant thymoma. © 2013 Elsevier Inc. Source

Long X.,Jinan University | Zeng J.,Jinan University | Zeng J.,Fuda Institute of Lung Cancer | Niu L.,Jinan University | And 9 more authors.
Cryobiology | Year: 2013

Pain caused by liver tumors can be alleviated by cryoablation, but little is known about the analgesic effects and duration of pain alleviation. We retrospectively reviewed the changes in the severity of pain before and after percutaneous cryoablation of hepatic tumors. Each patient enrolled in this study had a single hepatic tumor; patients with large tumors (major diameter, ≥5. cm) underwent transarterial chemoembolization (TACE) first and then cryoablation. Severe abdominal pain that was not controlled with long-lasting oral analgesics was treated with opioid injections. In all 73 study patients, severe abdominal pain was gradually eased 5. days after cryosurgery, completely disappeared after 15. days and did not recur for more than 8. weeks. There were no differences in analgesic effects between patients with hepatocellular carcinomas and those with liver metastasis (P> 0.05). The patients were divided into four groups depending on their pain outcomes: (i) immediate relief (n= 6), severe abdominalgia was no longer present after cryosurgery; (ii) delayed relief (n= 11), severe abdominalgia disappeared gradually within 15. days after the cryosurgery; (iii) always pain-free (n= 39), severe abdominalgia was not present before or after treatment; and (iv) new pain (n= 17), abdominalgia developed after treatment and disappeared within 15. days. In summary, percutaneous cryoablation of hepatic tumors caused short-term pain in some patients, but this pain disappeared within 15. days. Moreover, the pain-relieving effect of this treatment was sustained for at least 8. weeks, without severe side effects. © 2013 Elsevier Inc. Source

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