Percutaneous radiofrequency ablation for inoperable non-small cell lung cancer and metastases: Preliminary report
Percutaneous radiofrequency ablation for inoperable non-small cell lung cancer and metastases: Preliminary report
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DOI：
10.1148/radiol.2301020934
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发表时间：
2004-01-01
期刊：
影响因子：
19.7
通讯作者：
Kim, CS
中科院分区：
文献类型：
--
作者：
Lee, JM;Jin, GY;Kim, CS
目的：评估经皮计算机断层扫描（CT）引导下经胸射频（RF）消融治疗不能手术的非小细胞肺癌（NSCLC）和肺转移的技术可行性、疗效和并发症。材料与方法：26例27例非小细胞肺癌患者和4例5例肺转移患者在CT引导下使用冷尖端电极进行射频消融。由于疾病晚期（n = 20）和/或合并症（n = 4）或拒绝接受手术（n = 6），患者不适合手术。该手术的目的是治愈10例（33%）I期肿瘤患者，并将20例（67%）患者作为姑息治疗。在射频消融后立即、1个月、然后每3个月进行对比材料增强CT检查，以评估对治疗的反应。采用Kaplan-Meier分析计算每位患者的死亡时间，并确定肿瘤大小和凝血坏死程度对死亡时间的影响。结果：32个病灶中12个（38%）出现完全坏死；部分坏死（bbb50 %），其余20个（62%）病灶。肿瘤大小是实现完全坏死的主要鉴别因素。6个小于3cm的肿瘤（100%）完全坏死，而26个较大的肿瘤中只有6个（23%）完全坏死（P < 0.05）。完全坏死患者的平均生存期（119.7个月）明显优于部分坏死患者（8.7个月）（P < 0.01）。有3例（30例，占10%）主要并发症，包括急性呼吸窘迫综合征和2例需要开胸术的胸神经性胸。结论：射频消融似乎是一种安全且有前景的治疗无法手术的非小细胞肺癌和转移性肿瘤的方法。(C)d RSNA, 2003。
PURPOSE: To assess technical feasibility, efficacy, and complications of percutaneous computed tomography (CT)-guided transthoracic radiofrequency (RF) ablation for treating inoperable non-small cell lung cancer (NSCLC) and lung metastases.MATERIALS AND METHODS: Twenty-six patients with 27 NSCLCs and four patients with five lung metastases underwent RF ablation with cooled-tip electrodes with CT guidance. Patients were not candidates for surgery because of either advanced-stage disease (n = 20) and/or comorbid processes (n = 4) or refusal to undergo surgery (n = 6). The procedure was performed with the intent to cure in 10 (33%) patients with stage I tumors and as palliative therapy in 20 (67%) patients. Contrast material-enhanced CT was performed immediately, 1 month, and then every 3 months after RF ablation to evaluate the response to therapy. Time to death for each patient was calculated with Kaplan-Meier analysis, and the effect of tumor size and the extent of coagulation necrosis on time to death were determined.RESULTS: Complete necrosis was attained in 12 (38%) of 32 lesions; partial (>50%) necrosis, in the remaining 20 (62%) lesions. Tumor size was a major discriminator in achieving complete necrosis. Complete necrosis was attained in all six (100%) tumors smaller than 3 cm but only in six (23%) of 26 larger tumors (P < .05). Mean survival of patients with complete necrosis (119.7 months) was significantly better than that of patients with partial necrosis (8.7 months) (P < .01). There were three (in 30 patients, 10%) major complications, which included acute respiratory distress syndrome, and two pneurnothoraces that required thoracostomy.sCONCLUSION: RF ablation appears to be a safe and promising procedure for the treatment of inoperable NSCLC and metastases. (C)d RSNA, 2003.