1.Concept
Ar-He knife is the application of argon gas cold isolation technology to the medical field, which can effectively treat solid tumors such as lung cancer, liver cancer, brain tumor, and breast cancer. In 1998, the Ar-He knife was approved by FDA (Food and Drug Administration) and IEC (International Electrotechnical Commission) and EMC (Electro Magnetic Compatibility). Since the introduction of Ar-He knife in China in 1999, tens of thousands of tumor patients have been treated with Ar-He targeted cryoablation therapy, with an efficiency of over 90%. On the basis of Chinese medicine’s support, supplementation and regulation, this local minimally invasive ultra-low temperature cryoablation technology can be combined with chemotherapy, radiotherapy and biological therapy to treat tumors in a comprehensive manner, which can achieve satisfactory clinical effects.
2.Working Principle
Cryotherapy is one of the earliest minimally invasive tumor ablation techniques used in human history, which originated in the mid-19th century. 1845, British physician James Arnott pioneered modern cryotherapy by treating tumors with ice saline down to -24°C. In 1877, air, oxygen, hydrogen and helium were liquefied, and in 1907, physicians used dry ice (solid CO2, -70 Since 1950, liquid nitrogen (-196°C), a much lower temperature, has replaced dry ice as the main cold medium and has been injected directly into various tumors for treatment.
In 1993, the world’s first Cryocare Surgical System, based on the Joule-Thomson Principle of physics, was developed, using high pressure argon gas at room temperature as the cold medium and high pressure helium gas as the heat medium, which is powerful, easy to use, accurate in positioning and precise in efficacy, and has won the approval of the medical community. The Joule-Thomson principle, i.e. The Joule-Thompson principle, in which gas is throttled as it is ejected from a higher pressure area into a lower pressure area through a narrow micro-aperture. Most gases will drop in temperature when they experience throttling, such as argon and oxygen. Certain bodies, such as hydrogen and helium, increase in temperature instead.
Argon Helium Knife is a targeted therapy technology for tumor treatment and is the only high-tech medical system in the world that simultaneously combines the multiple efficacy of ultra-low temperature freezing at -150 degrees, interventional thermotherapy, large temperature reversal at 200 degrees and immune enhancement. It is essentially freezing + heat therapy for tumor treatment. When argon gas is released rapidly in the tip of the needle, it can freeze the diseased tissue to -120℃~-165℃ in ten seconds; when helium gas is released rapidly in the tip of the needle, it will produce rapid rewarming and warming, quickly thawing the ice ball, eliminating the tumor and killing the cancer cells more thoroughly and effectively. Moreover, the speed of cooling and warming, time and the size and shape of the ice ball can be precisely set and controlled. Therefore, it is superior to pure hyperthermia or pure cryotherapy. This technology is purely physical therapy, which has the ability to completely destroy tumors with exact treatment effect, treatment does not lead to the spread of cancer cells, minimally invasive and painless treatment process, fast recovery, no damage to normal tissues, unlike radiotherapy and chemotherapy, argon helium knife treatment has no toxic side effects, and can also effectively regulate the secretion of cytokines and antibodies (anti-tumor antibodies). It also has the advantages of low treatment cost and short hospitalization time. In 2003, the World Conference on Targeted Tumor Treatment recommended that argon helium knife is the first choice for middle and late stage lung cancer and liver cancer.
3.Treatment advantages
(1) Wide range of clinical indications
Ar-He knife can be used for ablation of almost all malignant and benign solid tumors and palliative treatment of advanced large tumors, which is the most widely used local ablation method among all kinds of local ablation methods, providing a new choice for patients who are unwilling to operate or cannot operate. It can be used for lung cancer treatment, benign lung tumor, liver cancer treatment, hepatic hemangioma, pancreatic cancer, breast cancer, breast hyperplasia, brain tumor, spinal meningioma, prostate cancer, prostate hyperplasia, kidney cancer, adrenal tumor, perineal tumor, uterine cancer, cervical cancer, ovarian cancer, penile cancer, skin cancer, melanoma, hemangioma, bone sarcoma, tonsil cancer, throat tumor, nasopharyngeal cancer, neurofibroma, liposarcoma (2) The treatment effects are precise and reliable.
(2) Reliable treatment effect
Ar-He knife treatment can be guided by various imaging devices, with convenient and accurate positioning, real-time display of treatment process and timely and reliable postoperative evaluation. The treatment target area has excellent visibility under various imaging devices. The cold knife’s built-in thermocouples and independent temperature probes allow for real-time monitoring of the tip and target area temperatures. Good intraoperative imaging and temperature monitoring can ensure precise control of the ablation zone, improve the success rate and reduce complications.
(3) Accurate and controllable target treatment
The target area in treatment is predictable and repeatable, which is more reliable and controllable than other local treatment means of radiofrequency ablation and microwave ablation, allowing preoperative planning, conformal and intraoperative monitoring.
(4) Flexible multi-incision conformation
Ar-He knife can be used to treat large tumors and multiple tumors simultaneously with multiple independently controlled cold knives. It is equipped with multiple sizes and shapes of cold knives and thermometric probes, each of which can form an ice ball of 0.5-1.0 cm in cross diameter and 4.0 cm in length. The high conformability and monitoring capability ensures maximum destruction of cancerous tissues and preservation of normal tissues.
(5) Complete green therapy
It physically crushes and destroys cancerous cells without coking and coagulation, and the surface antigen of the destroyed cancerous cells can stimulate human immune response. It does not destroy collagen and does not damage the supporting structure and function of tissues, so that the treatment can approach important structures such as large blood vessels, renal pelvis or near trachea.
(6) Rapid pain relief and pain removal
Rapid freezing can block nerve pathways, destroy nociceptive transmission, have pain relief and hemostatic effects, and is a natural anesthetic. The latest indication of Ar-He knife approved by FDA is freezing for pain relief, including cancer pain treatment, intraoperative and postoperative pain relief for advanced patients. The discomfort during treatment can be minimized and the pain relief requirement can be simplified (only local anesthesia is required), which enables patients to adapt well and recover quickly.
(7) Enhance the effect of comprehensive treatment
As a part of comprehensive and personalized tumor treatment, Ar-He knife can be combined with Chinese medicine treatment, surgery, radiotherapy, chemotherapy, interventional therapy and cellular biological therapy, i.e., it can be used in treatment or sequential treatment. It can quickly eliminate tumor load, reverse tumor drug resistance and immune evasion, enhance the sensitivity of local chemotherapy and radiotherapy, reduce the side effects of other therapies, and improve the effect of comprehensive tumor treatment.
(8) Minimally invasive treatment has obvious advantages
It can effectively expand the indications and eliminate the patient’s fear of treatment.
4.Comparison with other tumor treatment methods
(1) Chemotherapy: it can kill a certain percentage of tumor cells.
Anti-cancer drugs also have effects on normal cells, and patients will trigger a series of side effects after treatment, such as white blood cell and platelet reduction, hematuria, decreased immune function, and easy co-infection. In a short period of time, it is easy for the remaining tumor cells to grow and multiply again as well as metastasize.
(2) Radiotherapy: Inhibit and kill tumor cells
a. It is only effective for low differentiated cancer, but highly differentiated cancer is not sensitive to radiotherapy.
b. Most of the treatments are carried out in the form of external irradiation, which can cause harm to the normal cells of human body and damage the immune system.
c. Serious side effects, such as suppression of bone marrow (leukocyte and platelet reduction), dry skin, hair loss, fatigue, loss of appetite, etc., and even cause partial loss of function.
(3) Chinese medicine: good long-term efficacy with few side effects
The effect is slower. Mostly used for palliative treatment where surgery or radiotherapy cannot treat. Another type of treatment to supplement the qi and blood, regulate the internal organs, with the above types of treatment methods. However, for patients in the middle and late stages, the therapeutic effect is not obvious.
(4) Surgical therapy: For many benign tumors, surgical resection can obtain healing
The risk is high (such as brain, cervical spine, heart, etc.), surgical resection is not clean and complete, and it will cause great damage and bleeding to normal tissues.
(5) Immunotherapy: good long-term efficacy and small side effects
(6) Ar-He knife therapy
a. Minimally invasive and simple operation: most of the argon helium knife treatment is based on local anesthesia, and the minimally invasive puncture is usually performed under the guidance of B-ultrasound, CT or magnetic resonance, and the argon knife is accurately punctured into the tumor body under the guidance of CT or B-ultrasound positioning. After 15-20 minutes, the argon gas is turned off and the helium gas is activated. The rapid expansion of the helium gas at the tip of the knife rapidly heats up the tumor tissue in the ultra-low temperature state, which can rapidly increase the temperature of the tumor tissue from -140℃ to -20℃~40℃, thus performing rapid thermal therapy. After 3~5 minutes, the treatment is repeated once more. This alternating hot and cold therapy is particularly effective in destroying the diseased tissue. More importantly, because the argon helium knife cooling or heating is limited to the tip of the knife, the knife shaft does not cause hot or cold damage to the normal cellular tissues in the puncture path.
b. Safe, effective and no side effects: When patients receive argon helium knife cryoablation treatment for 1-2 weeks, the serum tumor antigen level decreases significantly and the tumor load is rapidly reduced. Tumors less than 4 cm in diameter can reduce the load by more than 95%; tumors larger than 5 cm in diameter can reduce the load by more than 80%; smaller tumors can achieve the effect of radical treatment and prolong the survival of patients. Moreover, argon helium knife does not have the side effects brought by chemotherapy and radiotherapy.
c. Effectively prevent blood metastasis of tumor cells. Improve anti-tumor immunity.
d.Improve anti-tumor immunity.
e. Enjoy medical reimbursement in Beijing.