CT-guided radiofrequency ablation: A potential complementary therapy for patients with unresectable primary lung cancer - A preliminary report of 33 patients
CT-guided radiofrequency ablation: A potential complementary therapy for patients with unresectable primary lung cancer - A preliminary report of 33 patients
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DOI：
10.2214/ajr.183.4.1831003
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发表时间：
2004-10-01
影响因子：
5
通讯作者：
Rossi, R
中科院分区：
文献类型：
--
作者：
Belfiore, G;Moggio, G;Rossi, R
OBJECTIVE.我们报告我们的初步评估的有效性，安全性，技术可行性和姑息性CT引导下射频消融术的并发症，不能切除的原发性肺恶性肿瘤。33名患有不可切除的恶性肺肿瘤的患者（26名男性和7名女性;年龄范围，44-75岁;平均年龄，66岁）接受了35次CT引导肿瘤消融术。治疗后6个月（29例）和1年（10例）分别行CT随访。在19例患者中，这些结果与6个月随访时CT引导细针穿刺活检或空芯针活检获得的细胞组织病理学评估相关。治疗后病灶的大小和CT表现与细胞组织学特征和临床评分相关。进行了35次技术成功的射频消融治疗。围手术期唯一的并发症是3例轻微气胸，5例痰痂和3例无症状胸腔积液。6个月随访时进行的对比增强CT显示4例完全消融和13例部分消融，11例稳定病变大小，1例病变大小增加。1年随访时进行的对比增强CT显示6例患者的病变大小不变，4例患者缩小。6个月的细胞组织学检查显示7个病灶完全凝固性坏死，12个病灶部分坏死。在6个月随访时，29例患者中有12例观察到治疗前症状的临床改善。8例患者在治疗后1年内死于非手术相关原因。我们的经验表明，射频消融术可以成功地用于不可切除的肺癌，作为放射或化学疗法的替代或补充治疗。有必要进行更大规模的研究，以充分评估其与其他治疗技术的潜在组合。
OBJECTIVE. We report our preliminary evaluation of the effectiveness, safety, technical feasibility, and complications of palliative CT-guided radiofrequency ablation of unresectable primary pulmonary malignancies.SUBJECTS AND METHODS. Thirty-three patients (26 men and seven women; age range, 44-75 years; mean age, 66 years) with unresectable malignant lung neoplasms underwent 35 CT-guided tumor ablation sessions. Follow-up CT was performed 6 months (29 cases) and 1 year (10 cases) after treatment. In 19 patients, these findings were correlated with cytohistopathologic assessment obtained with CT-guided fine-needle aspiration biopsy or core biopsy at 6-month follow-up. Size and CT appearance of the treated lesions were correlated with cytohistologic features and clinical scores.RESULTS. Thirty-five technically successful radiofrequency ablation treatments were performed. The only complications in the periprocedural period were three cases of minor pneumothorax, five cases of sputum cruentum, and three asymptomatic pleural effusions. Contrast-enhanced CT performed at 6-month follow-up showed four cases of complete and 13 cases of partial lesion ablation, 11 cases of stabilized lesion size, and one case of increased lesion size. Contrast-enhanced CT performed at 1-year follow-up showed unchanged lesion size in six cases and reduction in four cases. Six-month cytohistologic examinations showed total coagulation necrosis in seven lesions and partial necrosis in 12. Clinical improvement in pretreatment symptoms was observed in 12 of 29 patients seen at 6-month follow-up. Eight patients died within 1 year of treatment of non-procedure-related causes.CONCLUSION. Our experience suggests that radiofrequency ablation can be used successfully in unresectable lung cancer as an alternative or complementary treatment to radio-or chemotherapy. Larger studies are necessary to fully evaluate its potential combination with other treatment techniques.