[射频消融治疗非小细胞肺癌术后孤立性局部复发或转移的肺部肿瘤]
[Radiofrequency ablation for lung neoplasms with isolated postsurgical local recurrences or metastases of non-small cell lung cancer].
作者信息
Liu Baodong, Liu Lei, Hu Mu, Qian Kun, Li Yuanbo, Zhi Xiuyi
机构信息
Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
出版信息
Zhongguo Fei Ai Za Zhi. 2014 Jun 20;17(6):460-4. doi: 10.3779/j.issn.1009-3419.2014.06.04.
BACKGROUND
Primary lung cancer is one of the most common malignancies worldwide. Surgical resection remains the first choice for the treatment of early stage non-small cell lung cancer (NSCLC). Relapse after surgery sharply reduces the patient's life expectancy. This relapse is referred to as isolated postsurgical local recurrences or metastases (IPSLROM), which can be treated via local therapy to achieve long-term survival or cure. In recent years, radiofrequency ablation (RFA) has been increasingly used as a non-surgical treatment option for patients with primary and metastatic lung tumors. This study aims to evaluate the efficacy of RFA among patients with IPSLROM of NSCLC.
METHODS
A total of 20 patients underwent computerd tomograghy (CT)-guided RFA for lung neoplasm with IPSLROM of NSCLC (with unresectable disease because of poor lung reserve or multifocality) in our hospital between December 2008 and November 2013. These patients comprised 15 males and 5 females with a mean age of 69.2 years (range: 45-85). All patients exhibited pathological evidence of neoplastic lesion (14 tumors were adenocarcinoma, and six were squamous cell carcinoma). The mean size of the lesions was 3.9 cm (range: 2.0 cm to 8.0 cm). Treatment complications, progression-free survival (PFS), and survival parameters were retrospectively analyzed.
RESULTS
RFA was well tolerated by all patients with an average time of 34.3 min (range: 15 min to 60 min). Intraprocedural complications included eight cases of chest pain (40%). No procedure-related deaths occurred in all of the 20 ablation procedures. The median PFS was 25 months in all of the patients who received RFA. The median overall survival for the entire group of patients was 27.0 months. No differences were observed in the overall survival between patients with IPSLROM. The overall survival rates at 1 and 2 years after RFA were 92.9% and 57.0%, respectively.
CONCLUSIONS
RFA is a safe and effective procedure in unresectable lung tumors with IPSLROM of NSCLC.
背景
原发性肺癌是全球最常见的恶性肿瘤之一。手术切除仍然是早期非小细胞肺癌（NSCLC）治疗的首选方法。术后复发会大幅降低患者的预期寿命。这种复发被称为孤立性术后局部复发或转移（IPSLROM），可通过局部治疗实现长期生存或治愈。近年来，射频消融（RFA）越来越多地被用作原发性和转移性肺肿瘤患者的非手术治疗选择。本研究旨在评估RFA治疗NSCLC患者IPSLROM的疗效。
方法
2008年12月至2013年11月期间，我院共有20例NSCLC伴IPSLROM（因肺储备功能差或多灶性而无法切除）的患者接受了计算机断层扫描（CT）引导下的肺部肿瘤RFA治疗。这些患者包括15名男性和5名女性，平均年龄为69.2岁（范围：45 - 85岁）。所有患者均有肿瘤病变的病理证据（14例肿瘤为腺癌，6例为鳞状细胞癌）。病变的平均大小为3.9厘米（范围：2.0厘米至8.0厘米）。对治疗并发症、无进展生存期（PFS）和生存参数进行回顾性分析。
结果
所有患者对RFA耐受性良好，平均时间为34.3分钟（范围：15分钟至60分钟）。术中并发症包括8例胸痛（40%）。20例消融手术中均未发生与手术相关的死亡。所有接受RFA治疗的患者的中位PFS为25个月。整个患者组的中位总生存期为27.0个月。IPSLROM患者之间的总生存期未观察到差异。RFA后1年和2年的总生存率分别为92.9%和57.0%。
结论
RFA对于无法切除的NSCLC伴IPSLROM的肺部肿瘤是一种安全有效的治疗方法。
Zotero 插件