Comparative Study of Three Different Catheters for CT Imaging-Bronchoscopy-Guided Radiofrequency Ablation as a Potential and Novel Interventional Therapy for Lung Cancer
Comparative Study of Three Different Catheters for CT Imaging-Bronchoscopy-Guided Radiofrequency Ablation as a Potential and Novel Interventional Therapy for Lung Cancer
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DOI：
10.1378/chest.09-1065
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发表时间：
2010-04-01
期刊：
影响因子：
9.6
通讯作者：
Yoshida, Kazuo
中科院分区：
文献类型：
--
作者：
Tanabe, Tsuyashi;Koizumi, Tomonobu;Yoshida, Kazuo
背景资料：我们以前报道过，在正常羊肺中进行支气管镜引导的内冷射频消融（RFA）是一种安全、有效和可行的手术，无严重并发症。目的：本研究旨在探讨经支气管镜引导下内冷射频消融治疗非小细胞肺癌（NSCLC）的安全性、有效性和可行性。使用涉及消融时间的不同手术条件制备了三种类型的内部冷却电极导管头端：具有5 mm圆柱形活性尖端的内部冷却电极，功率输出为20 W，流速为50 mL/min，消融时间为30 s（n = 3），具有8 mm活性尖端的电极，具有4个珠，功率输出为20 W，流速为50 mL/min，和40 s（n = 3），以及具有10 mm活性尖端的电极，该电极具有5个微珠，20 W，50 mL/min和50 s（n = 4）。进行了CT图像引导、支气管镜引导、内冷RFA，患者接受了标准肺切除治疗。切除的肺组织进行组织病理学检查，以评估消融areas.Results：消融面积病理学评价与10 mm的活性尖端显着大于那些与5 mm的尖端。因此，消融区域根据头端长度和延长的消融时间而扩大。RFA过程中没有并发症，如支气管出血或气胸。结论：CT成像支气管镜引导下，内部冷却的RFA在人类是一个安全可行的程序，可能成为一个潜在的治疗工具，在医学上无法手术的I期非小细胞肺癌患者的局部控制。胸部2010; 137（4）：890-897
Background: We previously reported that bronchoscopy-guided, internally cooled radiofrequency ablation (RFA) in normal sheep lung was a safe, effective, and feasible procedure without major complications. Purpose: The aim of this study was to evaluate the safety, effectiveness, and feasible conditions of bronchoscopy-guided, internally cooled RFA as a clinical application for non-small cell lung cancer (NSCLC).Methods: Ten patients pathologically diagnosed with NSCLC and the clinical stage of T1N0MO were enrolled in the study. Three types of internally cooled electrode catheter tips were prepared using different procedure conditions involving ablation time: an internally cooled electrode with a 5-mm cylindrical active tip at a power output of 20 W, flow rate of 50 mL/min, and an ablation time of 30 s (n = 3), an electrode with an 8-mm active tip with four beads at 20 W, 50 mL/min, and 40 s (n = 3), and an electrode with a 10-mm active tip with five beads at 20 W, 50 mL/min, and 50 s (n = 4). CT image-guided, bronchoscopy-guided, internally cooled RFA was performed, and the patients underwent standard lung resection therapy. The resected lung tissue was examined histopathologically to assess the ablated areas.Results: Ablated areas pathologically evaluated with the 10-mm active tip were significantly larger than those with the 5-mm tip. Thus, the ablated areas were enlarged depending on the tip length and prolonged ablation time. There were no complications during RFA, such as bronchial bleeding or pneumothorax.Conclusions: CT imaging-bronchoscopy-guided, internally cooled RFA in humans is a safe and feasible procedure that could become a potential therapeutic tool for local control in medically inoperable patients with stage I NSCLC. CHEST 2010; 137(4):890-897