CT-guided PCT yielded low procedural morbidity given the extent of freezing, even near mediastinal structures. Ongoing advances in cryotechnology, imaging guidance, and treatment planning may help to avoid the degree of undertreatment of larger central masses observed in this study.

This study evaluated cryoablation on subcutaneously transplanted tumors of lung adenocarcinoma LA795 in T739 mice in vivo, in an effort to assess the feasibility of cryoablation in treatment of NSCLC. Subcutaneously transplanted lung adenocarcinoma LA795 was implanted into T739 mice yielding tumors of approximately 2.5 cm in diameter. Following cryoablation, the various modes of cell death were studied: necrosis in the central frozen zone by light microscopy and apoptosis in periphery of the frozen zone by in situ end labeling (TUNEL).Bc1-2 and bax expression were detected by immunohistochemical SABC procedures, and the cleavage and activation of Caspase 3 and PARP in peripheral zone by Western blot.We find that in central cryoablated zone, necrosis was the dominant mode of cell death occurring at three hours and four days post-thaw. The first three-hour necrosis peak involved approximately 47% of the tumor while the four-day peak increased in volume to 68% of the tumor. In peripheral cryoablation zone, definite cell apoptosis could be observed by morphological examination under light microscope and TUNEL staining, peaking at 8-16 h after cryoablation. Immunohistochemical results yielded little change in bcl-2 protein expression before and after cryoablation. However, bax protein expression was up-regulated significantly after cryoablation. In addition, cleavage and activation of Caspase-3 and PARP occurred in the peripheral freeze zone after the treatment.It indicated that Cryoablation efficiently induces cell death both by necrosis and apoptosis.Cryoablation appears to induce apoptosis in the peripheral freeze zone through the intrinsic mitochondrial caspase pathway based on bax upregulation. This observation allows us to suggest that cryoablation may be combined with chemotherapy to increase cancer destruction.

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The purpose of this study is to investigate the curative effect of the bronchoscope-guided interventional cryotherapy in the treatment of stenosis and obstruction of the airway, due to the advanced central lung cancer. A total of 20 cases of advanced central lung cancer were treated by 38 cycles of cryotherapy; the symptoms, as seen under the bronchoscope, were compared before and after treatment, so as to observe the curative effect. For all the subjects, there were the varying degrees of alleviation of cough, hemoptysis and dyspnea after treatment, disappearance of original obstructive pneumonia and pulmonary atelectasis, and the re-deoppilation of tracheal cavity. Ten subjects (50%) enjoyed the complete remission (CR), and nine subjects (45%) enjoyed the partial remission (PR), while only one subject showed no remission (NR), achieving a total efficiency of 95%. The bronchoscope-guided cryotherapy can be used for the treatment of endoluminal central lung cancer; it is able to reduce the size of the tumor, control the obstructive pneumonia, and improve hemoptysis and dyspnea, thereby significantly enhancing the patients' quality of life. When used for the treatment of narrow or obstructive central lung cancer in the airway, this therapeutic method is also safe and effective without obvious complication and adverse reaction. It provides a new choice for the treatment of lung cancer.