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肺射频消融术治疗手术干预后不可切除的复发性非小细胞肺癌。

Lung radiofrequency ablation for the treatment of unresectable recurrent non-small-cell lung cancer after surgical intervention.

机构信息

Department of Radiology, Mie University School of Medicine, Tsu, Mie, 514-8507, Japan.

出版信息

Cardiovasc Intervent Radiol. 2012 Jun;35(3):563-9. doi: 10.1007/s00270-011-0220-0. Epub 2011 Jul 6.

Abstract

PURPOSE

A retrospective evaluation was done of clinical utility of lung radiofrequency (RF) ablation in recurrent non-small-cell lung cancer (NSCLC) after surgical intervention.

METHODS

During May 2003 to October 2010, 44 consecutive patients (26 male and 18 female) received curative lung RF ablation for 51 recurrent NSCLC (mean diameter 1.7±0.9 cm, range 0.6 to 4.0) after surgical intervention. Safety, tumor progression rate, overall survival, and recurrence-free survival were evaluated. Prognostic factors were evaluated in multivariate analysis.

RESULTS

A total of 55 lung RF sessions were performed. Pneumothorax requiring pluerosclerosis (n=2) and surgical suture (n=1) were the only grade 3 or 4 adverse events (5.5%, 3 of 55). During mean follow-up of 28.6±20.3 months (range 1 to 98), local tumor progression was found in 5 patients (11.4%, 5 of 44). The 1-, 3-, and 5-year overall survival rates were 97.7, 72.9, and 55.7%, respectively. The 1- and 3-year recurrence-free survival rates were 76.7 and 41.1%, respectively. Tumor size and sex were independent significant prognostic factors in multivariate analysis. The 5-year survival rates were 73.3% in 18 women and 60.5% in 38 patients who had small tumors measuring≤3 cm.

CONCLUSION

Our results suggest that lung RF ablation is a safe and useful therapeutic option for obtaining long-term survival in treated patients.

摘要

目的

回顾性评估肺射频 (RF) 消融术在外科干预后复发性非小细胞肺癌 (NSCLC) 中的临床应用价值。

方法

2003 年 5 月至 2010 年 10 月,44 例连续患者(26 例男性,18 例女性)因外科干预后 51 例复发性 NSCLC(平均直径 1.7±0.9cm,范围 0.6 至 4.0)接受了根治性肺 RF 消融术。评估了安全性、肿瘤进展率、总生存率和无复发生存率。采用多因素分析评估了预后因素。

结果

共进行了 55 次肺 RF 治疗。需要胸膜固定术(n=2)和手术缝合(n=1)的气胸是唯一的 3 级或 4 级不良事件(5.5%,55 次中的 3 次)。在平均 28.6±20.3 个月(范围 1 至 98)的随访期间,5 例患者发现局部肿瘤进展(11.4%,44 例中的 5 例)。1、3 和 5 年总生存率分别为 97.7%、72.9%和 55.7%。1 年和 3 年无复发生存率分别为 76.7%和 41.1%。肿瘤大小和性别是多因素分析中的独立显著预后因素。18 例女性的 5 年生存率为 73.3%,38 例肿瘤直径≤3cm 的患者的 5 年生存率为 60.5%。

结论

我们的结果表明,肺 RF 消融术是一种安全有效的治疗选择,可以为接受治疗的患者获得长期生存。

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