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[结直肠癌(CRC)肺转移灶的射频消融(RFA)——一年随访]

[Radiofrequency ablation (RFA) of lung metastases from colorectal cancer (CRC)-one-year follow-up].

作者信息

Steinke K, King J, Glenn D, Morris D L

机构信息

Universitätsinstitut für Radiologie, Kantonsspital Basel.

出版信息

Radiologe. 2004 Jul;44(7):687-92. doi: 10.1007/s00117-004-1071-3.

Abstract

Assess the safety and evidence of efficacy of RFA for colorectal (CRC) lung metastases with follow up to 1 year. Twenty-three patients had percutaneous RFA for 52 colorectal pulmonary metastases under fluoro-CT. Patients received IV conscious sedation and local analgesia with routine hospitalisation/monitoring for 24 h post RFA. Patients had CT scanning at 1 month and then 3 monthly with serum CEA assessment monthly and 3 monthly. All ablations were technically successful. Tumor diameter ranged from 0.3 to 4.2 cm. Pneumothorax occurred in 43% (10 of 23) of patients. Six patients required intercostal chest drain placement. Six patients had a second RFA, 4 for new lesions and 2 patients had a previously treated lesion retreated. Median admission was 2.0 days (range 1-9). Median follow-up is 428 days (range 173-829), with data reported to 1 year in this paper. Five patients died at 5, 6, 8, 8 and 12 months post RFA from extra-pulmonary (1) or widespread (4) disease. One patient developed malignant pleural effusion at 6 months after RFA. Cavitation was seen in nine treated lesions (17%), all resolved with scar tissue contraction by 12 months. Eighteen patients with CT scan follow-up at one year have 40 lesions classified as: disappeared (17), decreased (5), stable/same size (4), increased (14). Percutaneous imaging-guided RFA of multiple CRC pulmonary metastases is a minimally invasive treatment option with modest morbidity. A significant proportion of patients show good evidence of successful local control at one year.

摘要

评估射频消融术(RFA)治疗结直肠癌(CRC)肺转移瘤长达1年的安全性和疗效证据。23例患者在氟-CT引导下对52个结直肠癌肺转移瘤进行了经皮RFA治疗。患者接受静脉清醒镇静和局部镇痛,术后常规住院/监测24小时。患者在1个月时进行CT扫描,然后每3个月进行一次,每月和每3个月进行血清癌胚抗原(CEA)评估。所有消融技术均成功。肿瘤直径为0.3至4.2厘米。43%(23例中的10例)的患者发生气胸。6例患者需要放置肋间胸腔引流管。6例患者进行了第二次RFA,4例针对新病灶,2例对先前治疗过的病灶进行再次治疗。中位住院时间为2.0天(范围1 - 9天)。中位随访时间为428天(范围173 - 829天),本文报告的数据截至1年。5例患者在RFA术后5、6、8、8和12个月因肺外(1例)或广泛(4例)疾病死亡。1例患者在RFA术后6个月出现恶性胸腔积液。9个治疗病灶(17%)出现空洞形成,到12个月时均因瘢痕组织收缩而消退。18例接受1年CT扫描随访的患者有40个病灶,分类如下:消失(17个)、缩小(5个)、稳定/大小不变(4个)、增大(14个)。经皮影像引导下对多个结直肠癌肺转移瘤进行RFA是一种微创治疗选择,发病率适中。相当一部分患者在1年时显示出局部控制成功的良好证据。

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