Midterm local efficacy and survival after radiofrequency ablation of lung tumors with minimum follow-up of 1 year:: Prospective evaluation
Midterm local efficacy and survival after radiofrequency ablation of lung tumors with minimum follow-up of 1 year:: Prospective evaluation
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DOI：
10.1148/radiol.2402050807
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发表时间：
2006-08-01
期刊：
影响因子：
19.7
通讯作者：
Ducreux, Michel
中科院分区：
文献类型：
--
作者：
de Baere, Thierry;Palussiere, Jean;Ducreux, Michel
目的：为了前瞻性地评估局部疗效的射频（RF）消融治疗肺肿瘤，与一个最小的随访期为1 year.Materials和Methods：60例（34名男性和26名女性;年龄范围，27-81岁;平均年龄，66岁）与100肺肿瘤给予书面知情同意书被纳入一项前瞻性研究，是由当地伦理委员会批准。每例患者有5个或更少的肿瘤，每个肿瘤的直径小于40 mm（平均值+/-标准差，17 mm +/- 10）。在计算机断层扫描（CT）引导下对肿瘤进行射频消融。在治疗后48小时内以及治疗后2、4、6、9和12个月获得随访CT研究，以评估治疗结果和并发症。在RF ablation.Results之前和4周之后获得肺肺功能测定法测量值：100个靶向肿瘤中的97个被治疗，并且需要163次RF消融（每个肿瘤1.68次），每次持续14分钟+/-8，在74次手术期间递送。18个月CT局部治疗不完全的估计发生率为7%（95%置信区间：3%，14%）/肿瘤和12%（95%置信区间：5%，23%）/患者。消融面积至少比初始肿瘤大4倍，则可预测完全消融治疗（P = 0.02）。直径小于2 cm的肿瘤有更好的疗效趋势（P = 0.066）。18个月的总生存率和无肺疾病生存率分别为71%和34%。主要的不良事件是气胸，发生在54%的手术中，但仅9%的手术需要胸管。比较射频消融术前和消融术后2个月内的肺功能测定结果，未发现呼吸功能的改变（P = 0.51）。结论：射频消融术具有较高的局部疗效，耐受性良好。
Purpose: To prospectively evaluate the local efficacy of radiofrequency (RF) ablation of lung neoplasms, with a minimum follow-up period of 1 year.Materials and Methods: Sixty patients (34 men and 26 women; age range, 27-81 years; mean age, 66 years) with 100 lung tumors gave written informed consent to be enrolled in a prospective study that was approved by the local ethics committee. There were five or fewer tumors per patient, each with a diameter of less than 40 mm (mean +/- standard deviation, 17 mm +/- 10). RF ablation was performed in tumors by using computed tomographic (CT) guidance. Follow-up CT studies were obtained within 48 hours after treatment and at 2, 4, 6, 9, and 12 months thereafter to evaluate treatment outcome and complications. Lung spirometry measurements were obtained before and 4 weeks after RF ablation.Results: Ninety- seven of 100 targeted tumors were treated and required 163 RF ablations (1.68 per tumor), each lasting 14 minutes +/- 8, delivered during 74 procedures. The 18- month estimated rate of incomplete local treatment at CT was 7% (95% confidence interval: 3%, 14%) per tumor and 12% (95% confidence interval: 5%, 23%) per patient. An ablation area at least four times larger than the initial tumor was predictive of complete ablation treatment (P = .02). There was a trend toward better efficacy for tumors smaller than 2 cm in diameter (P = .066). Overall survival and lung disease-free survival at 18 months were 71% and 34%, respectively. The main adverse event was a pneumothorax, which occurred in 54% of procedures, but a chest tube was required in only 9% of the procedures. No modification of respiratory function was found when spirometry measurements obtained before and within 2 months after RF ablation were compared (P = .51).Conclusion: RF ablation has a high local efficacy and is well tolerated.