Percutaneous computed tomography-guided radiofrequency thermal ablation of small unresectable lung tumours
Percutaneous computed tomography-guided radiofrequency thermal ablation of small unresectable lung tumours
复制标题
经皮计算机断层扫描引导射频热消融治疗不可切除的小型肺部肿瘤
DOI：
10.1183/09031936.06.00052905
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发表时间：
2006
影响因子：
24.3
通讯作者：
E. Pozzi
中科院分区：
文献类型：
--
作者：
S. Rossi;R. Dore;A. Cascina;V. Vespro;F. Garbagnati;L. Rosa;V. Ravetta;A. Azzaretti;P. D. Tolla;G. Orlandoni;E. Pozzi
本研究的目的是评估射频热消融（RFTA）治疗非小细胞肺癌（NSCLC）和结直肠癌（CRC）孤立性肺转移（MET）的安全性和有效性。共有 31 名患者（其中 15 名患有 NSCLC，16 名患有 CRC 肺部 MET），具有 36 个肺部肿瘤结节（平均±标准差直径：22±8 mm，范围：10–35 mm），接受了计算机断层扫描 (CT) 引导下使用可扩张电极的 RFTA。每次 RFTA 疗程之前和之后（即刻和 30±5 天）均进行增强 CT，以评估即时结果和并发症，并在 RFTA 后 3 个月和 6 个月以及此后每 6 个月重复一次，以评估长期结果。放射学完全坏死定义为肿瘤部位的非增强区域等于或大于治疗肿瘤；肿瘤部位持续增强表明治疗不完整。局部复发定义为肿瘤大小增加和/或肿瘤部位组织增强。通过 39 次 RFTA 治疗和 42 次电极插入，实现了 36 个肿瘤的完全放射学坏死。没有观察到重大并发症或死亡。六名患者在手术过程中经历了轻度至中度疼痛。气胸 5 例，无需引流；肺炎 4 例，经抗生素治疗成功。平均随访 11.4±7.7 个月（范围为 3-36 个月）后，总体局部复发率为 13.9%（NSCLC 和 CRC-MET 患者分别为 20% 和 9.5%）。 31 名患者中有 19 名 (61.3%) 还活着（其中 15 名显然没有患病），12 名 (38.7%) 已经死亡（其中 3 名死于与癌症无关的原因）。射频热消融似乎是一种安全、有效的方法，可以完全消融小非小细胞肺癌和肺结直肠癌转移瘤。
The aim of the current study was to evaluate the safety and the efficacy of radiofrequency thermal ablation (RFTA) for the treatment of nonsmall cell lung cancer (NSCLC) and isolated pulmonary metastases (METs) from colorectal cancer (CRC). A total of 31 patients (15 with NSCLCs and 16 with CRC lung METs), with 36 lung tumour nodules (mean±sd diameter: 22±8 mm, range: 10–35 mm) underwent computed tomography (CT)-guided RFTA using expandable electrodes. Contrast-enhanced CT was performed before and after (immediately and 30±5 days) each RFTA session to assess immediate results and complications and repeated 3 and 6 months post-RFTA, as well as every 6 months thereafter, to evaluate long-term results. Complete radiological necrosis was defined as a nonenhancing area at the tumour site that was equal to or larger than the treated tumour; persistence of enhancement at the tumour site indicated incomplete treatment. Local recurrence was defined as an increase in tumour size and/or enhancing tissue at the tumour site. Complete radiological necrosis of the 36 tumours was achieved with 39 RFTA sessions and 42 electrode insertions. No major complications or deaths were observed. Six patients experienced mild-to-moderate pain during the procedure. There were five cases of pneumothorax, none requiring drainage and four cases of pneumonia, which were successfully treated with antibiotics. After a mean follow-up of 11.4±7.7 months (range of 3–36 months), the overall local recurrence rate was 13.9% (20 and 9.5% for NSCLC and CRC-METs patients, repectively). Nineteen of the 31 (61.3%) patients were alive (15 apparently disease free) and 12 (38.7%) had died (three from causes unrelated to their cancer). Radiofrequency thermal ablation seems to be a safe, effective method for producing complete ablation of small nonsmall cell lung cancers and pulmonary colorectal cancer metastases.