Iguchi Toshihiro, Hiraki Takao, Gobara Hideo, Mimura Hidefumi, Fujiwara Hiroyasu, Tajiri Nobuhisa, Sakurai Jun, Yasui Kotaro, Date Hiroshi, Kanazawa Susumu
Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
J Vasc Interv Radiol. 2007 Jun;18(6):733-40. doi: 10.1016/j.jvir.2007.02.024.
The authors retrospectively evaluated the safety and effectiveness of percutaneous radiofrequency ablation of lung tumors close to the heart or aorta.
Forty-two tumors (mean diameter, 25 mm +/- 16; range, 5-73 mm) located less than 10 mm from the heart or aorta were treated with radiofrequency ablation in 47 sessions. Lung tumors were classified into two groups according to their distance from the heart or aorta: group A (n = 27) comprised tumors at a distance of 1-9 mm; group B (n = 15) comprised contiguous tumors (distance, 0 mm). The safety and technique effectiveness of the procedure, defined as no evidence of local tumor progression, were evaluated.
Radiofrequency ablation was feasible for all the 42 tumors. Procedural complications included asymptomatic pleural effusion (n = 5), small pneumothorax (n = 11), pneumothorax that necessitated chest tube placement (n = 4), and lung abscess (n = 1). No complications related to the specific tumor location, such as the accidental insertion of the electrode into the heart or aorta, pericardial effusion, arrhythmia, or cardiac infarction, occurred. The overall primary technique effectiveness rate was 75.8%, 45.9%, and 45.9% at 6, 12, and 24 months, respectively. This rate in group A (94.7%, 69.3%, and 69.3% at 6, 12, and 24 months, respectively) was significantly (P < .001) higher than that in group B (42.9% and 8.6% at 6 and 12 months, respectively).
Radiofrequency ablation of lung tumors close to the heart or aorta was safely performed. The local control of tumors contiguous to the heart or aorta was considerably lower compared with the tumors that were close but not contiguous to these structures.
作者回顾性评估经皮射频消融治疗靠近心脏或主动脉的肺肿瘤的安全性和有效性。
对47例次接受射频消融治疗的42个肿瘤(平均直径25 mm±16;范围5 - 73 mm)进行研究,这些肿瘤距离心脏或主动脉小于10 mm。根据肺肿瘤与心脏或主动脉的距离将其分为两组:A组(n = 27)包括距离为1 - 9 mm的肿瘤;B组(n = 15)包括紧邻肿瘤(距离为0 mm)。评估该操作的安全性和技术有效性,技术有效性定义为无局部肿瘤进展的证据。
42个肿瘤均可行射频消融治疗。操作并发症包括无症状性胸腔积液(n = 5)、小气胸(n = 11)、需要放置胸管的气胸(n = 4)和肺脓肿(n = 1)。未发生与特定肿瘤位置相关的并发症,如电极意外插入心脏或主动脉、心包积液、心律失常或心肌梗死。总体主要技术有效率在6、12和24个月时分别为75.8%、45.9%和45.9%。A组的该有效率(在6、12和24个月时分别为94.7%、69.3%和69.3%)显著高于B组(在6和12个月时分别为42.9%和8.6%)(P <.001)。
靠近心脏或主动脉的肺肿瘤射频消融治疗安全可行。与靠近但不紧邻这些结构的肿瘤相比,紧邻心脏或主动脉的肿瘤局部控制率明显较低。