New paradigm of modern tumor treatment: the application of minimally invasive therapy

Introduction: When we talk about the treatment of tumor, the first thing that comes to our mind is surgery, radiotherapy and chemotherapy, but with the progress of science and technology, minimally invasive treatment of tumor has emerged in the modern tumor treatment mode. Minimally invasive medicine is a new method of combining treatment and diagnosis based on medical imaging as the guide and minimally invasive puncture technology. With the guidance of medical imaging, it makes our localization and treatment more precise, and therefore has the advantages of less trauma, less pain, and exact efficacy. Minimally invasive interventional treatment integrates contemporary high and new technologies, including modern medical imaging technology-guided radiofrequency, microwave, irreversible electroporation ablation therapy, high-intensity focused ultrasound (HIFU), radioactive particle implantation, photodynamic, lumpectomy technology, endoscopic technology, transcatheter arterial chemoembolization (TACE), etc., which are less invasive and more effective, and are increasingly recognized and accepted by medical and patient groups. Minimally invasive interventional therapy combined with multidisciplinary comprehensive treatment has changed the situation of one “knife” dominating in the cold weapon era of tumor treatment. The progress of modern medical imaging and image-guided minimally invasive therapy as well as bioimmunotherapy has triggered the progress of tumor treatment concept, which is changing from the previous destructive treatment thinking, destructive treatment strategy and destructive treatment mode to constructive treatment thinking, constructive treatment strategy and constructive treatment mode. That is, under the premise of effective tumor inactivation, the physiological functions of patients are protected to the greatest extent, the immune functions of patients are protected to the greatest extent, and the quality of life of patients is protected and improved to the greatest extent. The multidisciplinary comprehensive treatment represented by minimally invasive treatment combined with biological immunotherapy and Chinese herbal medicine is the concrete embodiment of constructive treatment mode, which becomes the 4th major tumor treatment mode after surgery, chemotherapy and radiotherapy. 1.Intra-arterial drug perfusion The drug perfusion through catheter into the tumor blood supply artery can significantly increase the local drug concentration of tumor while the systemic drug concentration is lower, which can improve the therapeutic effect and also reduce the toxic side effects. Scope of application: (1) Perfusion chemotherapy: preoperative, postoperative chemotherapy and late palliative chemotherapy for malignant tumors; (2) Perfusion vasoconstrictor for hemorrhagic diseases; (3) Perfusion vasodilator and thrombolytic agent for ischemic diseases; (4) Perfusion antibiotics for intractable infectious diseases. 2.Vascular embolization Vascular embolization, as the name implies, is the use of various embolic materials to block the blood supply through the catheter embolization of diseased vessels, thereby causing ischemic necrosis of diseased tissues or organs to achieve the purpose of treatment. The scope of application: (1) preoperative and palliative treatment of various solid tumors; (2) internal organs resection such as spleen, thyroid, kidney embolization; (3) arteriovenous malformations, arteriovenous fistula embolization treatment; (4) refractory haemorrhage such as haemoptysis, gastrointestinal and urinary, genital bleeding; 3, high-intensity focused ultrasound (HIFU) – non-invasive treatment HIFU is precisely the use of ultrasound as the energy source. Using its penetration and focusability, it focuses the low-energy ultrasound outside the body on the lesion in the body and generates instant high temperature at the focus to kill the tumor tissue. Scope of application: pancreatic cancer, uterine fibroids, retroperitoneal, abdominal and pelvic solid tumors, liver tumors (left liver), prostate hyperplasia and prostate cancer (those who are not suitable for surgery); treatment of retroperitoneal lymph node metastasis with obvious advantages of pain relief. 4.Radiofrequency and microwave tumor ablation treatment Through alternating radiofrequency current or microwave, the local tissue temperature reaches 65-100℃, thus causing necrosis of tumor tissue and achieving therapeutic effect. Applicable scope: (1) Tumor cannot be resected; (2) Tumor diameter is less than 7cm; (3) Less than 8 lesions; (4) Overall volume of lesions is less than 20% of the total volume of liver; (5) Any extrahepatic lesions are limited to nodules (6 or less, 3cm or smaller). Through alternating radio frequency current or microwave to make the local tissue temperature reach 65-100℃, so as to necrosis the tumor tissue and achieve the therapeutic effect. 5.Argon-Helium cryotherapy Through the rapid cooling of argon gas to form an ice ball in the cell, maintain it for 10-15 minutes and then warm it up with helium gas, using the principle of thermal expansion and cold contraction to make the tumor cells rupture, so as to achieve the therapeutic effect. Scope of application: liver cancer, pancreatic cancer, rectal and anal canal cancer, lung cancer, kidney cancer, bladder cancer, prostate cancer, uterine cancer, uterine fibroid, ovarian cancer, meningioma, brain glioma, neurofibroma, chordoma, benign and malignant tumors of bone or spine, breast cancer, breast fibroid, skin cancer, nasopharyngeal cancer, thyroid cancer and cancer pain relief. 6.125I radioactive particle implantation The 125I radioactive particles are directly implanted into the tumor to kill the tumor cells through the continuous release of low-energy γ-rays, which has less impact on the surrounding normal tissues due to its tissue penetration distance of 1.7cm, thus achieving accurate radiotherapy. Scope of application: (1) Unresectable primary or secondary malignant progressive tumors; (2) Tumors with maximum diameter ≤10cm; (3) Malignant tumors resistant to external radiotherapy; (4) Malignant tumors with strong recovery ability from sublethal radiation damage; (5) Malignant tumors with high degree of differentiation and slow growth. In the face of the above minimally invasive treatment methods, the best treatment plan should be formulated according to the individual differences of patients, hospital equipment and the technical level of medical personnel in clinical application. In this way, the patients can benefit the most with the least trauma.