Koelblinger Claus, Strauss Sandra, Gillams Alice
Department of Radiology, KH Barmherzige Schwestern Ried, Schlossberg 1, 4910, Ried im Innkreis, Austria,
Cardiovasc Intervent Radiol. 2014 Feb;37(1):147-53. doi: 10.1007/s00270-013-0644-9. Epub 2013 May 14.
Resection is the mainstay of management in patients with sarcoma lung metastases, but there is a limit to how many resections can be performed. Some patients with inoperable disease have small-volume lung metastases that are amenable to thermal ablation. We report our results after radiofrequency ablation (RFA).
This is a retrospective study of patients treated from 2007 to 2012 in whom the intention was to treat all sites of disease and who had a minimum CT follow-up of 4 months. Treatment was performed under general anesthesia/conscious sedation using cool-tip RFA. Follow-up CT scans were analyzed for local control. Primary tumor type, location, grade, disease-free interval, prior resection/chemotherapy, number and size of lung tumors, uni- or bilateral disease, complications, and overall and progression-free survival were recorded.
Twenty-two patients [15 women; median age 48 (range 10-78) years] with 55 lung metastases were treated in 30 sessions. Mean and median tumor size and initial number were 0.9 cm and 0.7 (range 0.5-2) cm, and 2.5 and 1 (1-7) respectively. Median CT and clinical follow-up were 12 (4-54) and 20 (8-63) months, respectively. Primary local control rate was 52 of 55 (95 %). There were 2 of 30 (6.6 %) Common Terminology Criteria grade 3 complications with no long-term sequelae. Mean (median not reached) and 2- and 3-year overall survival were 51 months, and 94 and 85 %. Median and 1- and 2-year progression-free survival were 12 months, and 53 and 23 %. Prior disease-free interval was the only significant factor to affect overall survival.
RFA is a safe and effective treatment for patients with small-volume sarcoma metastases.
手术切除是肉瘤肺转移患者治疗的主要手段，但可进行的切除次数有限。一些无法手术的患者有小体积的肺转移灶，适合热消融治疗。我们报告了射频消融（RFA）后的结果。
这是一项对2007年至2012年接受治疗患者的回顾性研究，这些患者旨在治疗所有疾病部位，且CT随访至少4个月。治疗在全身麻醉/清醒镇静下使用冷循环射频消融进行。分析随访CT扫描以评估局部控制情况。记录原发肿瘤类型、位置、分级、无病间期、既往手术/化疗情况、肺肿瘤数量和大小、单侧或双侧疾病、并发症以及总生存期和无进展生存期。
22例患者（15例女性；中位年龄48岁，范围10 - 78岁）有55个肺转移灶，共接受了30次治疗。肿瘤平均和中位大小及初始数量分别为0.9 cm和0.7（范围0.5 - 2）cm，以及2.5个和1个（1 - 7个）。CT和临床中位随访时间分别为12（4 - 54）个月和20（8 - 63）个月。55个转移灶中52个（95%）实现了原发灶局部控制。30次治疗中有2次（6.6%）出现常见术语标准3级并发症，无长期后遗症。平均（未达到中位值）及2年和3年总生存率分别为51个月、94%和85%。中位及1年和2年无进展生存率分别为12个月、53%和23%。既往无病间期是影响总生存期的唯一显著因素。
RFA是小体积肉瘤转移患者的一种安全有效的治疗方法。
