Department of Medical Imaging and Interventional Radiology, Cancer Center and State Key Laboratory of Oncology in South China, Sun Yat Sen University, Guangzhou, China.
Cancer. 2011 Nov 15;117(22):5182-8. doi: 10.1002/cncr.26128. Epub 2011 Apr 26.
Microwave ablation has recently been developed as a safe and effective treatment for a variety of tumors. The authors evaluated the safety and efficacy of computed tomography (CT)-guided percutaneous microwave ablation of adrenal malignant tumors.
Nine patients between 41 and 83 years of age (average age, 54 years) with adrenal carcinoma (a total of 10 lesions) received CT-guided percutaneous water-cooled microwave ablation. The 9 cases included 1 primary adrenocortical carcinoma and 8 metastatic carcinomas (4 from lung cancer, 2 from hepatocellular carcinoma, 1 from intrahepatic cholangiocarcinoma, and 1 from left tibial osteosarcoma). Of the 8 metastatic cases, 7 were unilateral, and 1 was bilateral. All cases were pathologically confirmed by aspiration biopsy or postsurgical biopsy. The tumor diameters ranged from 2.1 cm to 6.1 cm (average, 3.8 cm). The average number of ablation sites was 1.5 sites (1-3 sites), and the average accumulated ablation time was 7.7 minutes (4-15 minutes). The procedures were performed using a cooled-shaft antenna.
The patients were followed for 3-37 months, with an average of 11.3 months. Nine of 10 lesions were completely necrotized after first treatment. The other lesion was completely necrotized after 2 treatments. One of the patients experienced hypertensive crisis during treatment. No patient experienced recurrent tumor at the treated site, and this lack of recurrence indicated effective local control. All patients had progression of metastatic disease at extra-adrenal sites.
CT-guided percutaneous water-cooled microwave ablation is a minimally invasive and effective method for the treatment of adrenal carcinoma.
微波消融术最近已发展成为治疗多种肿瘤的安全有效的方法。作者评估了 CT 引导下经皮水冷微波消融治疗肾上腺恶性肿瘤的安全性和有效性。
9 例年龄 41-83 岁（平均年龄 54 岁）的肾上腺癌患者（共 10 个病灶）接受 CT 引导下经皮水冷微波消融治疗。9 例包括 1 例原发性肾上腺皮质癌和 8 例转移性癌（4 例来自肺癌，2 例来自肝细胞癌，1 例来自肝内胆管癌，1 例来自左胫骨骨肉瘤）。8 例转移性病例中，7 例为单侧，1 例为双侧。所有病例均经抽吸活检或术后活检病理证实。肿瘤直径 2.1-6.1cm（平均 3.8cm）。消融部位平均 1.5 个（1-3 个），累计消融时间 7.7 分钟（4-15 分钟）。该操作使用冷轴天线进行。
患者随访 3-37 个月，平均 11.3 个月。首次治疗后，10 个病灶中有 9 个完全坏死。另一个病灶在两次治疗后完全坏死。1 例患者在治疗过程中出现高血压危象。无患者在治疗部位出现肿瘤复发，且这种无复发表明局部控制有效。所有患者在肾上腺外部位均出现转移性疾病进展。
CT 引导下经皮水冷微波消融术是治疗肾上腺癌的一种微创、有效的方法。
