Percutaneous imaging-guided radiofrequency ablation in patients with colorectal pulmonary metastases: 1-year follow-up
Percutaneous imaging-guided radiofrequency ablation in patients with colorectal pulmonary metastases: 1-year follow-up
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DOI：
10.1245/aso.2004.04.008
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发表时间：
2004-02-01
影响因子：
3.7
通讯作者：
Morris, DL
中科院分区：
文献类型：
--
作者：
Steinke, K;Glenn, D;Morris, DL
背景资料：我们评估的安全性和证据的有效性，射频消融（RFA）的结直肠癌肺转移瘤随访1 year.Methods：23例患者经皮射频消融52结直肠癌肺转移瘤下的荧光计算机断层扫描（CT）。患者接受静脉清醒镇静和局部镇痛，常规住院，并在RFA后24小时进行监测。术后1个月及以后每3个月复查CT，每月及每3个月复查血清癌胚抗原。肿瘤直径范围为0.3至4.2 cm。43%（10/23）的患者发生气胸。6名患者需要肋间胸腔引流管放置。6例患者接受了第二次RFA，4例为新发病变，2例为既往治疗病变的再次治疗。中位住院时间为2.0天（范围：1-9天）。中位随访时间为428天（范围：173-829天）;本文报告的数据为1年。5例患者在RFA后5、6、8、8和12个月死于肺外（n = 1）或广泛（n = 4）疾病。1例患者在RFA后6个月发生恶性胸腔积液。在9处治疗病变（17%）中观察到空洞;所有病变均在12个月时消退，瘢痕组织收缩。18例患者在7年时进行CT扫描随访，有40个病灶被分类为消失（n = 17），缩小（n = 5），稳定/相同大小（n = 4），或增加（n = 14）。结论：经皮成像引导RFA多发结直肠肺转移瘤是一种微创治疗选择，发病率适中。相当大比例的患者在1年时显示出成功局部控制的良好证据。
Background: We assessed the safety and evidence of efficacy of radiofrequency ablation (RFA) for colorectal lung metastases with follow-up to 1 year.Methods: Twenty-three patients had percutaneous RFA for 52 colorectal pulmonary metastases under fluoro-computed tomography (CT). Patients received intravenous conscious sedation and local analgesia with routine hospitalization and monitoring for 24 hours after RFA. Patients had CT scanning at 1 month and then every 3 months, with serum carcinoembryonic antigen assessment monthly and every 3 months.Results: All ablations were technically successful. Tumor diameter ranged from .3 to 4.2 cm. Pneumothorax occurred in 43% (10 of 23) of patients. Six patients required intercostal chest drain placement. Six patients had a second RFA, four for new lesions and two for re-treatment of a previously treated lesion. The median admission was 2.0 days (range, 1-9 days). The median follow-up was 428 days (range, 173-829 days); data are reported to 1 year in this article. Five patients died at 5, 6, 8, 8, and 12 months after RFA from extrapulmonary (n = 1) or widespread (n = 4) disease. One patient developed a malignant pleural effusion at 6 months after RFA. Cavitation was seen in nine treated lesions (17%); all resolved with scar tissue contraction by 12 months. Eighteen patients with CT scan follow-up at 7 year have 40 lesions classified as disappeared (n = 17), decreased (n = 5), stable/same size (n = 4), or increased (n = 14).Conclusions: Percutaneous imaging-guided RFA of multiple colorectal pulmonary metastases is a minimally invasive treatment option with modest morbidity. A significant proportion of patients show good evidence of successful local control at 1 year.