Microwave ablation for non-small cell lung cancer with synchronous solitary extracranial metastasis
Microwave ablation for non-small cell lung cancer with synchronous solitary extracranial metastasis
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DOI：
10.1007/s00432-020-03176-z
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发表时间：
2020-05-01
影响因子：
3.6
通讯作者：
Zou, Zhigeng
中科院分区：
文献类型：
--
作者：
Ni, Yang;Ye, Xin;Zou, Zhigeng
目的局部治疗包括手术或放疗已被报道用于治疗伴有同步孤立转移的非小细胞肺癌（NSCLC），而其他局部消融治疗的研究很少。在此，我们总结了微波消融（MWA）治疗伴同步孤立性颅外转移的NSCLC患者原发性和转移性病灶的单中心经验。患者和方法我们回顾性筛选了2014年1月至2019年6月的研究所数据库。识别并分析了接受MWA治疗的伴有原发性和转移性病灶的同步颅外孤立性转移的NSCLC患者。结果1472例IV期NSCLC患者中，38例同时发生颅外孤立性转移，29例同时接受MWA治疗。最常见的远处转移是对侧肺转移（14例），其次是骨转移（6例）、肝转移（4例）、肾上腺转移（3例）和胸膜转移（1例）。中位OS和PFS分别为21.5和12.5个月。N0患者的PFS（中位18.5 vs. 8.0个月）和OS（中位42.7 vs. 19.0个月）显著延长。此外，全身治疗被证明是PFS更好的预后因素（12.9 vs 7.5个月）。临床病理因素包括年龄、组织学、T分期、PS评分和转移部位与生存率无显著相关性。结论MWA可作为非小细胞肺癌合并同时性孤立性颅外转移的一种替代治疗方法。
AimsLocal therapy including surgery or radiotherapy has been reported for the treatment of non-small cell lung cancer (NSCLC) with synchronous solitary metastasis, while studies with other local ablative treatment are rare. Here, we summarized our single-center experience of microwave ablation (MWA) for both primary and metastatic lesions in NSCLC patients with synchronous solitary extracranial metastases. Patients and methods We retrospectively screened our institute database from January 2014 to Jun 2019. NSCLC patients with synchronous extracranial solitary metastasis with primary and metastatic lesions that were treated with MWA were identified and analyzed. Results Of the 1472 stage IV NSCLC patients found, 38 were diagnosed with synchronous extracranial solitary metastasis and 29 of them received MWA for primary and metastatic lesions. The most common distant metastases were contralateral lung metastases (14 cases), followed by bone (6), liver (4), adrenal gland (3) and pleura metastases (1). Median OS and PFS was 21.5 and 12.5 months, respectively. Patients with N0 had significantly longer PFS (median 18.5 vs. 8.0 months) and OS (median 42.7 vs. 19.0 months). In addition, systemic therapy was showed to be a prognostic factor for better PFS (12.9 vs. 7.5 months). Clinical pathological factors including age, histology, T stage, PS score, and metastasis locations are not significantly associated with survival. Conclusions MWA may serve as an alternative treatment for NSCLCs with synchronous solitary extracranial metastases.