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[经皮射频消融治疗肾细胞癌的保守治疗——7例肾肿瘤4例患者的治疗实验——]

[Conservative therapy by percutaneous radiofrequency ablation of renal cell carcinomas--therapeutic experiments of four patients with seven renal tumors--].

作者信息

Karashima Takashi, Inoue Keiji, Shimamoto Tsutomu, Yamasaki Ichiro, Kamada Masayuki, Shuin Taro

机构信息

The Department of Urology, School of Medicine, Kochi University.

出版信息

Hinyokika Kiyo. 2006 Apr;52(4):241-7.

Abstract

We report 7 renal cell carcinomas in 4 patients treated by percutaneous image-guided radiofrequency ablation (RFA). The mean age of the patients was 59 years (male: 2, female: 2). All 4 were imperative cases. Two patients (5 tumor) had hereditary multiple renal cell carcinomas with von Hippel-Lindau (VHL) disease. The other two patients had sporadic renal cell carcinomas. RFA was performed guided by computed tomography under conscious sedation with local anesthetics. The mean size of the treated tumors was 4.5 (1.8-8.1) cm. Impedance-regulated RF energy from a generator at 94 (45-130) watts was applied at 11 (8-14) min intervals. The average procedure time was 91 (45-165) minutes. The maximum tissue temperature reached 82 (56-91) degrees C immediately after ablation. Three of the 7 lesions (42.9 %) were locally well controlled during the mean follow-up period of 6.3 (4-9) months. The two patients with VHL disease developed visceral metastasis after There were no major complications. Minor complications encountered included flank pain, nausea, perinephritic hematoma and fever. Although percutaneous image-guided RFA showed limited success in large or central renal tumors, the therapy against small exophytic renal tumors would be well tolerable and successful.

摘要

我们报告了4例患者共7个肾细胞癌,接受了经皮影像引导下的射频消融(RFA)治疗。患者的平均年龄为59岁(男性2例,女性2例)。所有4例均为必要病例。2例患者(5个肿瘤)患有伴有冯·希佩尔-林道(VHL)病的遗传性多发性肾细胞癌。另外2例患者患有散发性肾细胞癌。在局部麻醉下清醒镇静状态下,在计算机断层扫描引导下进行RFA。治疗肿瘤的平均大小为4.5(1.8 - 8.1)cm。来自发生器的阻抗调节射频能量为94(45 - 130)瓦,以11(8 - 14)分钟的间隔施加。平均手术时间为91(45 - 165)分钟。消融后立即达到的最高组织温度为82(56 - 91)摄氏度。在平均6.3(4 - 9)个月的随访期内,7个病灶中有3个(42.9%)局部控制良好。2例VHL病患者在……后发生内脏转移。无重大并发症。遇到的轻微并发症包括胁腹疼痛、恶心、肾周血肿和发热。尽管经皮影像引导下的RFA在大型或中央型肾肿瘤中显示出有限的成功率,但针对小的外生性肾肿瘤的治疗耐受性良好且成功。 (注:原文中“after There were no major complications.”表述有误,但按要求未修改直接翻译)

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