원발성 폐암에서 냉동수술의 치료 효과

Background: Cryosurgery has been used to treat primary malignant pulmonary tumors at our institute since November 2004. In this study we analyzed our treatment results and complication rates. Material and Method: A retrospective study using medical charts and imaging data was conducted involving 17 patients with a total of 17 malignant pulmonary tumors who were treated between November 2004 and March 2007. Fourteen patients were males and 3 were females. The median age of the patients was 64 years (range, 54∼77 years). The average size of the tumors was 48.8 mm (range, 36∼111 mm) in diameter. The patients were followed with chest CT scans 7 days, 1 month, 3 months, and 6 months postoperatively. PET scans were obtained between 6 and 9 months postoperatively. The treatment response was analyzed according to the Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Result: Six months after treatment, 6 tumors (35.3%) showed a complete response, 4 (23.5%) had a partial response, 3 (17.6%) had stable disease, and 4 (23.5%) showed disease progression. In tumors ＜4 cm in diameter, a complete response was reported in 50% of the tumors. A χ²-test showed that in tumors ＜4 cm in diameter, the p-value for results better than a partial response was 0.034. With respect to procedural complications, there was 1 case of blood-tinged sputum which resolved spontaneously within 1 or 2 days, a spontaneously relieved case of subcutaneous emphysema, and 1 patient with a fever. There were no mortalities and the average hospital stay was 6.3 days. Conclusion: The effects of cryosurgery on primary lung cancer is greatest in patients with small tumors. Considering the facts that cryosurgery is minimally invasive, has a low complication rate, and can be performed repetitively, we believe that it may play an important role in the treatment of high risk lung cancer patients.