Kuang Ming, Lu Ming D, Xie Xiao Y, Xu Hui X, Mo Li Q, Liu Guang J, Xu Zuo F, Zheng Yan L, Liang Jin Y
Department of Hepatobiliary Surgery, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China.
Radiology. 2007 Mar;242(3):914-24. doi: 10.1148/radiol.2423052028. Epub 2007 Jan 17.
To prospectively investigate whether the ablation zone induced with microwaves could be increased by delivering greater energy with a cooled-shaft antenna.
All studies were animal care and ethics committee approved. Written informed consent was obtained from all patients. Microwave ablation was performed by using a cooled-shaft antenna in 48 ex vivo and 12 in vivo experiments with porcine livers. The coagulation diameters achieved in different microwave ablation parameter groups (60-90 W for 5-25 minutes) were compared. Ninety patients (78 men, 12 women; mean age, 53 years; age range, 20-82 years) with 133 0.8-8.0-cm (mean, 2.7 cm +/- 1.5 [standard deviation]) primary or metastatic liver cancers were treated with the same microwave ablation technique. Complete ablation (CA) and local tumor progression (LTP) rates were determined. Generalized estimating equations were used to compare differences in tumor size, ablation zone diameter, and CA and LTP rates between different patient subgroups.
In the ex vivo livers, in vivo livers, and liver cancers, one application of microwave energy with 80 W for 25 minutes produced mean coagulation diameters of 5.6 x 7.4 cm, 3.5 x 5.9 cm, and 3.6 x 5.0 cm, respectively. Skin burn was not observed. CA rates in small (<or=3.0-cm), intermediate (3.1-5.0-cm), and large (5.1-8.0-cm) liver cancers were 94% (81 of 86), 91% (31 of 34), and 92% (12 of 13), respectively. During a mean follow-up period of 17.4 months, LTP occurred in seven (5%) treated cancers. There was a significant difference in LTP rate between the cirrhosis and no-cirrhosis groups (P = .03). Four patients had major complications.
Delivery of greater microwave energy with cooled-shaft antennas yielded large ablation zones in ex vivo and in vivo livers and in liver cancers. Effective local tumor control was achieved during one microwave ablation session.
前瞻性研究使用冷却杆状天线传递更大能量是否能增大微波诱导的消融区。
所有研究均获动物护理和伦理委员会批准。所有患者均签署了书面知情同意书。在48例猪肝脏离体实验和12例猪肝脏活体实验中，使用冷却杆状天线进行微波消融。比较不同微波消融参数组（60 - 90瓦，持续5 - 25分钟）所达到的凝固直径。90例患者（78例男性，12例女性；平均年龄53岁；年龄范围20 - 82岁），患有133个直径0.8 - 8.0厘米（平均2.7厘米±1.5[标准差]）的原发性或转移性肝癌，采用相同的微波消融技术进行治疗。确定完全消融（CA）率和局部肿瘤进展（LTP）率。使用广义估计方程比较不同患者亚组之间肿瘤大小、消融区直径以及CA和LTP率的差异。
在离体肝脏、活体肝脏和肝癌中，一次施加80瓦微波能量持续25分钟，平均凝固直径分别为5.6×(7.4)厘米、3.5×(5.9)厘米和3.6×(5.0)厘米。未观察到皮肤烧伤。小（≤3.0厘米）、中（3.1 - 5.0厘米）和大（5.1 - 8.0厘米）肝癌的CA率分别为94%（86例中的81例）、91%（34例中的31例）和92%（13例中的12例）。在平均17.4个月的随访期内，7例（5%）接受治疗的癌症出现LTP。肝硬化组和非肝硬化组的LTP率存在显著差异（P = 0.03）。4例患者出现严重并发症。
使用冷却杆状天线传递更大的微波能量，在离体肝脏、活体肝脏和肝癌中产生了较大的消融区。在一次微波消融过程中实现了有效的局部肿瘤控制。
