Naya Yoshio, Nakamura Terukazu, Oishi Masakatsu, Ueda Takashi, Nakanishi Hiroyuki, Naitoh Yasuyuki, Hongo Fumiya, Kamoi Kazumi, Okihara Koji, Tanaka Osamu, Yamagami Takuji, Yamada Kei, Miki Tsuneharu
Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Int J Clin Oncol. 2015 Dec;20(6):1192-7. doi: 10.1007/s10147-015-0824-5. Epub 2015 Apr 30.
The aim of this study was to assess the efficacy of radio-frequency ablation (RFA) for metastatic lung or liver tumors of germ cell tumors (GCTs) after chemotherapy.
RFA with computed tomography guidance and monitoring was performed in 24 patients with 48 metastatic lung or liver tumors of GCTs. Group A consisted of 9 patients with tumor marker normalization after salvage chemotherapy and group B consisted of 15 patients without tumor marker normalization in spite ofintensive treatment.
Out of 48 tumors, 41 tumors in 21 patients were evaluated for the efficacy of the RFA treatment. Of the 41 tumors, successful ablation was achieved in 34 (82.9 %). The patients in group A had significantly better survival than the patients in group B (p = 0.0003). In group A, all 9 patients are still alive with no evidence of disease (NED). Patients with a solitary tumor had significantly better survival than those with multiple tumors (p = 0.0247). In group B, 2 patients are alive with NED, 1 patient is alive with disease, and the remaining 12 patients have died a tumor-related death. Three cases of pneumothorax requiring intubation were observed.
RFA is less invasive than surgery and is an effective treatment option for curative and palliative therapy as an alternative to invasive salvage surgery for post-chemotherapeutic metastatic lung or liver lesions from GCT.
本研究旨在评估化疗后射频消融(RFA)治疗生殖细胞肿瘤(GCT)肺或肝转移瘤的疗效。
对24例患有48个GCT肺或肝转移瘤的患者进行了计算机断层扫描引导和监测下的RFA治疗。A组由9例挽救性化疗后肿瘤标志物恢复正常的患者组成,B组由15例尽管接受了强化治疗但肿瘤标志物仍未恢复正常的患者组成。
48个肿瘤中,对21例患者的41个肿瘤进行了RFA治疗疗效评估。在这41个肿瘤中,34个(82.9%)成功消融。A组患者的生存期明显优于B组患者(p = 0.0003)。在A组中,所有9例患者均存活,无疾病证据(NED)。单发肿瘤患者的生存期明显优于多发肿瘤患者(p = 0.0247)。在B组中,2例患者存活且无疾病,1例患者存活但有疾病,其余12例患者死于肿瘤相关死亡。观察到3例需要插管的气胸病例。
RFA比手术侵入性小,是一种有效的治疗选择,可作为GCT化疗后肺或肝转移病变侵入性挽救手术的替代方法,用于根治性和姑息性治疗。