Abstract:

Objective　To investigate the effects of CT-guided percutaneous microwave ablation on alleviating cancer-related pain in patients with metastatic non-small cell lung cancer (NSCLC). Methods　This study is a randomized controlled trial involving 104 patients diagnosed with metastatic NSCLC and experiencing cancer-related pain symptoms at Zaozhuang Chest Hospital from March 2023 to September 2024. Patients were divided into a conventional group (58 cases) and an observation group (46 cases) based on different analgesic protocols. In the conventional group, there were 32 males and 26 females, aged (62.60±7.74) years; pathological types included 48 cases of adenocarcinoma and 10 cases of squamous cell carcinoma. In the observation group, there were 26 males and 20 females, aged (60.26±7.15) years; pathological types included 38 cases of adenocarcinoma and 8 cases of squamous cell carcinoma. The conventional group received standard analgesic medications, while the observation group underwent CT-guided percutaneous microwave ablation in addition to standard pain relief. The degree of cancer-related pain [visual analogue scale (VAS)] and the incidence of breakthrough pain were compared between the two groups before treatment and at 1, 3, and 10 weeks post-treatment. Functional status [Karnofsky Performance Status (KPS) score] and quality of life [Functional Assessment of Cancer Therapy-Lung (FACT-L) score] were assessed before treatment and one week after treatment. Complications during the treatment period were also observed in both groups. Statistical analysis was performed using Fisher's exact probability method, χ² test, and t test. Results　Before treatment and at 1, 3, and 10 weeks post-treatment, the VAS scores in the observation group were (8.24±1.02, 2.89±0.77, 2.93±0.65, 3.24±0.64) points, while those in the conventional group were (8.33±1.21, 4.57±1.14, 4.10±1.05, 4.12±0.82) points. Both groups showed a significant reduction in VAS scores compared to pre-treatment, with the observation group scores being lower than those of the conventional group, and all differences were statistically significant (all P<0.001). Within one week post-treatment, the observation group experienced fewer instances of breakthrough pain compared to the control group [(3.26±1.08) times/week vs. (6.50±1.41) times/week] (t=12.351, P<0.001). One week after treatment, the KPS and FACT-L scores in the observation group were higher than those in the conventional group [(74.78±5.57) points vs. (68.36±5.23) points and (104.26±5.85) points vs. (96.33±4.39)points] (all P<0.001). The incidence of nausea, vomiting, constipation, excessive sedation, and numbness or atrophy at the puncture site during analgesic treatment showed no statistically significant differences between the two groups (all P>0.05). Conclusion　CT-guided percutaneous microwave ablation is effective in rapidly alleviating cancer-related pain in patients with metastatic NSCLC and positively impacts their functional status and quality of life.

Key words:

Non-small cell lung cancer, CT-guided percutaneous microwave ablation, Cancerous pain, Quality of life

摘要：

目的　探究CT引导下经皮微波消融术对转移性非小细胞肺癌（NSCLC）患者癌性疼痛的缓解效果。方法　本研究为随机对照试验，选取2023年3月至2024年9月在枣庄市胸科医院确诊为转移性NSCLC且伴癌性疼痛症状的104例患者作为研究对象，根据镇痛方案不同分为常规组（58例）与观察组（46例），常规组中男32例、女26例，年龄（62.60±7.74）岁，病理类型：腺癌48例、鳞癌10例；观察组中男26例、女20例，年龄（60.26±7.15）岁，病理类型：腺癌38例、鳞癌8例。常规组给予常规止痛药物缓解疼痛，观察组在常规组基础上应用CT引导下经皮微波消融术的止痛方式。比较两组患者在治疗前及治疗1、3、10周后的癌性疼痛程度［视觉模拟评分法（VAS）］及暴发痛发作次数，比较两组在治疗前及治疗1周后功能状态［卡氏功能状态（KPS）评分］及生存质量［癌症治疗功能性量表（FACT-L）］评分，观察两组患者在治疗期间的并发症发生情况。采用Fisher精确概率法、χ²检验、t检验、F检验进行统计分析。结果　治疗前、治疗1、3、10周后，观察组VAS评分为（8.24±1.02、2.89±0.77、2.93±0.65、3.24±0.64）分，常规组为（8.33±1.21、4.57±1.14、4.10±1.05、4.12±0.82）分，两组VAS评分均较治疗前明显降低，且观察组均低于常规组，差异均有统计学意义（均P<0.001）。治疗后1周内观察组的暴发痛发作次数少于对照组［（3.26±1.08）次/周比（6.50±1.41）次/周］（t=12.351，P<0.001）。治疗1周后，观察组的KPS、FACT-L评分均高于常规组［（74.78±5.57）分比（68.36±5.23）分、（104.26±5.85）分比（96.33±4.39）分］（均P<0.001）。两组镇痛治疗期间恶心、呕吐、便秘、过度镇静、穿刺处皮肤麻木萎缩发生率差异均无统计学意义（均P>0.05）。结论　采用CT引导下经皮微波消融术治疗有助于转移性NSCLC患者的癌性疼痛得到迅速且有效地缓解，对于提高患者的功能状态及生存质量有积极作用。

关键词:

非小细胞肺癌, CT引导下经皮微波消融术, 癌性疼痛, 生存质量