In addition to surgery, ablation** provides another option for patients who are not willing to operate or do not have the indication for surgery, and the reasonable use of cryoablation** can also play the effect of "1+1>2", strengthen the "lethality" of multiple and distant tumors, and the application scenarios and applicable tumor types are also relatively wide, Xiong Bin, director of the interventional department of the First Affiliated Hospital of Guangzhou Medical University, reminded that cancer patients should not give up the hope of **, and can go to the interventional department of the hospital to evaluate whether they have cryoablation** Indications.
Guidelines for solid tumors such as liver cancer recommend that extremely early-stage tumors can be considered for ablation in addition to surgical resection, and there is little difference between the two in terms of efficacy.
Director Xiong Bin introduced that many cancer patients are diagnosed in the middle and advanced stages of clinical diagnosis, and ablation is mainly used to destroy tumors or reduce tumor burden.
In the past, due to the large size of some tumors and some adjacent to important tissues such as **, bones, nerves, etc., safer cryoablation ** was the main choice, including argon-helium knife, liquid nitrogen targeted knife, etc., which reached an extremely low temperature through the freezer, like a needle entering the lesion to form an "ice ball" and "freeze to death" tumor cells.
With the progress of technology, from simple cryoablation to compound ablation, Director Xiong Bin introduced that only one puncture hole is needed to find the location of the tumor, which can reduce the temperature to minus 196, and the temperature can rise to 85 after rewarming.
Director Xiong Bin said that if thermal ablation is performed on a location close to the nerve distribution, it may bring discomfort and pain to the patient due to high temperature, and a big advantage of cryoablation is that it has analgesic effect, especially the cold and heat composite ablation has a definite curative effect, strong targeting, and does not require general anesthesia, has a better sense of experience, effectively inactivates tumor activity, and can also play a pain-relieving effect.
Cryoablation technology also has a key role in stimulating the release of tumor antigens, inducing the body to produce an immune response, and then cooperating with immune checkpoint inhibitors to produce a "distance effect" and amplify the effect of immunosuppressants. ”
Director Xiong Bin introduced some classic cases of cryoablation, one of which is a patient with metastatic lung cancer, the lung nodule is close to the pleura, and it is a metastatic cancer, if the surgical resection of the trauma may be relatively large, and because the lesion is close to the pleura, the use of thermal ablation may cause greater pain, even if the use of *** is also a certain difficulty. During the ablation process, the entire lesion was wrapped in an "ice hockey puck", and the patient did not have any pain or discomfort, and successfully completed the cryoablation of lung metastases**, and was discharged from the hospital one day after surgery.
There was a case in the hospital that impressed Director Xiong Bin deeply, a patient with advanced melanoma had multiple liver metastases and bone metastases, and the conventional methods were used, and then he was cryoablized for the metastases in the liver, and then continued to combine with the immunosuppressant PD1, and it was surprising that the patient's liver metastases and metastases in the bones had subsided," This case has given us a lot of confidence, even if we are already a patient with advanced tumors, we try our best to do our best, as long as the patient's organ function in all aspects, such as liver function, kidney function, etc., is not bad, and can tolerate cryoablation, we hope to do it as much as possible, maybe there will be some unexpected effects. ”
Director Xiong Bin emphasized that clinical interventional ablation technology has its own advantages, disadvantages and indications, such as cryoablation** has certain requirements for the patient's platelet level, so some patients with liver cirrhosis may not be suitable for cryoablation, or need to improve the platelet level to accept cryoablation**.
Therefore, when formulating a tumor ablation plan, experienced doctors will make individualized decisions based on the specific situation of the patient, such as the location of the lesion, the type of tumor, etc.
In addition to ablation, there are many interventional methods that can be used to accurately and minimally invasive tumor lesions, such as chemotherapy drug perfusion, embolization, angioplasty, iodine-125 particles, Y90 microspheres, ozone, laser, radiofrequency thermocoagulation and collagenase injection, etc., to various tumors and vascular lesions. If you are in need, you can go to the Oncology and Vascular Interventional Clinic for a detailed consultation.
Supervising expert: Xiong Bin, chief physician of the Department of Intervention, The First Affiliated Hospital of Guangzhou Medical University.