射频消融治疗局部进展期胰腺癌的可行性和安全性。

Feasibility and safety of radiofrequency ablation for locally advanced pancreatic cancer.

机构信息

Hepatopancreatobiliary Unit, University of Verona, Verona, Italy.

出版信息

Br J Surg. 2010 Feb;97(2):220-5. doi: 10.1002/bjs.6800.

DOI:10.1002/bjs.6800

PMID:20069610

Abstract

BACKGROUND

: Radiofrequency ablation (RFA) may be a valuable treatment option for locally advanced pancreatic cancer. The present study examined its feasibility and safety.

METHODS

: Fifty patients with locally advanced pancreatic cancer were studied prospectively. Ultrasound-guided RFA was performed during laparotomy. The main outcome measures were short-term morbidity and mortality.

RESULTS

: The tumour was located in the pancreatic head or uncinate process in 34 patients and in the body or tail in 16; median diameter was 40 (interquartile range 30-50) mm. RFA was the only treatment in 19 patients. RFA was combined with biliary and gastric bypass in 19 patients, gastric bypass alone in eight, biliary bypass alone in three and pancreaticojejunostomy in one. The 30-day mortality rate was 2 per cent. Abdominal complications occurred in 24 per cent of patients; in half they were directly associated with RFA and treated conservatively. Three patients with surgery-related complications needed reoperation. Reduction of RFA temperature from 105 degrees C to 90 degrees C resulted in a significant reduction in complications (ten versus two of 25 patients; P = 0.028). Median postoperative hospital stay was 10 (range 7-31) days.

CONCLUSION

: RFA of locally advanced pancreatic cancer is feasible and relatively well tolerated, with a 24 per cent complication rate.

摘要

背景

射频消融（RFA）可能是局部晚期胰腺癌的一种有价值的治疗选择。本研究旨在评估其可行性和安全性。

方法

前瞻性研究了 50 例局部晚期胰腺癌患者。在剖腹手术期间进行超声引导下的 RFA。主要观察指标为短期发病率和死亡率。

结果

肿瘤位于胰头部或钩突部 34 例，体尾部 16 例；肿瘤直径中位数为 40（四分位距 30-50）mm。19 例患者仅接受 RFA 治疗。19 例患者 RFA 联合胆管和胃旁路手术，8 例患者单独进行胃旁路手术，3 例患者单独进行胆管旁路手术，1 例患者进行胰十二指肠吻合术。30 天死亡率为 2%。24%的患者发生腹部并发症；其中一半与 RFA 直接相关，经保守治疗治愈。3 例手术相关并发症患者需要再次手术。将 RFA 温度从 105°C 降低至 90°C 显著降低了并发症的发生率（25 例患者中，分别为 10 例和 2 例；P=0.028）。术后中位住院时间为 10（7-31）天。