Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, INF 110, 69120 Heidelberg, Germany.
Cardiovasc Intervent Radiol. 2013 Jun;36(3):731-7. doi: 10.1007/s00270-012-0468-z. Epub 2012 Aug 28.
This study was designed to evaluate the clinical efficacy of CT-guided bipolar and multipolar radiofrequency ablation (RF ablation) of renal cell carcinoma (RCC) and to analyze specific technical aspects between both technologies.
We included 22 consecutive patients (3 women; age 74.2 ± 8.6 years) after 28 CT-guided bipolar or multipolar RF ablations of 28 RCCs (diameter 2.5 ± 0.8 cm). Procedures were performed with a commercially available RF system (Celon AG Olympus, Berlin, Germany). Technical aspects of RF ablation procedures (ablation mode [bipolar or multipolar], number of applicators and ablation cycles, overall ablation time and deployed energy, and technical success rate) were analyzed. Clinical results (local recurrence-free survival and local tumor control rate, renal function [glomerular filtration rate (GFR)]) and complication rates were evaluated.
Bipolar RF ablation was performed in 12 procedures and multipolar RF ablation in 16 procedures (2 applicators in 14 procedures and 3 applicators in 2 procedures). One ablation cycle was performed in 15 procedures and two ablation cycles in 13 procedures. Overall ablation time and deployed energy were 35.0 ± 13.6 min and 43.7 ± 17.9 kJ. Technical success rate was 100 %. Major and minor complication rates were 4 and 14 %. At an imaging follow-up of 15.2 ± 8.8 months, local recurrence-free survival was 14.4 ± 8.8 months and local tumor control rate was 93 %. GFR did not deteriorate after RF ablation (50.8 ± 16.6 ml/min/1.73 m(2) before RF ablation vs. 47.2 ± 11.9 ml/min/1.73 m(2) after RF ablation; not significant).
CT-guided bipolar and multipolar RF ablation of RCC has a high rate of clinical success and low complication rates. At short-term follow-up, clinical efficacy is high without deterioration of the renal function.
本研究旨在评估 CT 引导下双极和多极射频消融（RF 消融）治疗肾细胞癌（RCC）的临床疗效，并分析两种技术之间的具体技术差异。
我们纳入了 22 例连续患者（3 例女性；年龄 74.2 ± 8.6 岁），这些患者在 28 例 RCC 中接受了 28 次 CT 引导下的双极或多极 RF 消融治疗（直径 2.5 ± 0.8 cm）。手术采用一种市售的 RF 系统（Celon AG Olympus，柏林，德国）进行。分析了 RF 消融程序的技术方面（消融模式[双极或多极]、应用器数量和消融循环次数、总消融时间和部署能量以及技术成功率）。评估了临床结果（局部无复发生存率和局部肿瘤控制率、肾功能[肾小球滤过率（GFR）]）和并发症发生率。
12 例手术采用双极 RF 消融，16 例手术采用多极 RF 消融（14 例手术使用 2 个应用器，2 例手术使用 3 个应用器）。15 例手术进行了 1 个消融循环，13 例手术进行了 2 个消融循环。总消融时间和部署能量分别为 35.0 ± 13.6 min 和 43.7 ± 17.9 kJ。技术成功率为 100%。主要和次要并发症发生率分别为 4%和 14%。在 15.2 ± 8.8 个月的影像学随访中，局部无复发生存率为 14.4 ± 8.8 个月，局部肿瘤控制率为 93%。RF 消融后 GFR 未恶化（50.8 ± 16.6 ml/min/1.73 m² 术前 vs. 47.2 ± 11.9 ml/min/1.73 m² 术后；无显著差异）。
CT 引导下双极和多极 RF 消融治疗 RCC 的临床成功率高，并发症发生率低。在短期随访中，疗效高，肾功能无恶化。
