Division of Interventional Radiology, Department of Radiology, University of Insubria, Varese, Italy.
J Vasc Interv Radiol. 2013 Oct;24(10):1513-20. doi: 10.1016/j.jvir.2013.07.005.
To evaluate the safety and efficacy of percutaneous microwave (MW) ablation treatment in locally advanced, nonresectable, nonmetastatic pancreatic head cancer.
Ten patients with pancreatic head cancer treated with percutaneous (n = 5) or laparotomic (n = 5) MW ablation were retrospectively reviewed. The MW generator used (45 W at 915 MHz) was connected by coaxial cable to 14-gauge straight MW antennas with a 3.7- or 2-cm radiating section. One or two antennae were used, with an ablation time of 10 minutes. Ultrasonographic (US) and combined US/cone-beam computed tomographic (CT) guidance were used in five patients each. Follow-up was performed by CT after 1, 3, 6, and, when possible, 12 months. Tumor response was assessed per Response Evaluation Criteria In Solid Tumors (version 1.1) and Choi criteria. The feasibility, safety, and major and minor complications associated with quality of life (QOL) were recorded prospectively.
The procedure was feasible in all patients (100%). One late major complication was observed in one patient, and no visceral injury was detected. No patient had further surgery, and all minor complications resolved during the hospital stay. An improvement in QOL was observed in all patients despite a tendency to return to preoperative levels in the months following the procedure, without the influence of minor complications. No repeat treatment was performed.
Despite the small number of patients, the present results can be considered encouraging, showing that MW ablation is a feasible approach in the palliative treatment of pancreatic tumors.
评估经皮微波(MW)消融治疗局部晚期、不可切除、无转移的胰头癌的安全性和疗效。
回顾性分析 10 例接受经皮(n=5)或剖腹(n=5)MW 消融治疗的胰头癌患者。使用的 MW 发生器(915MHz 时 45W)通过同轴电缆连接到带有 3.7 或 2cm 辐射段的 14 号直 MW 天线。使用一根或两根天线,消融时间为 10 分钟。五名患者分别采用超声(US)和联合 US/锥形束 CT 引导。术后 1、3、6 个月进行 CT 随访,如有可能,术后 12 个月进行 CT 随访。根据实体瘤反应评估标准(第 1.1 版)和 Choi 标准评估肿瘤反应。前瞻性记录可行性、安全性、与生活质量(QOL)相关的主要和次要并发症。
所有患者(100%)均可行该手术。1 例患者术后出现 1 例迟发性严重并发症,无内脏损伤。无患者行进一步手术,所有轻微并发症均在住院期间得到解决。尽管术后数月 QOL 有改善趋势,但所有患者的 QOL 均有所改善,且轻微并发症无影响。未行重复治疗。
尽管患者数量较少,但目前的结果仍令人鼓舞,表明 MW 消融是一种可行的治疗方法,适用于胰腺肿瘤的姑息治疗。