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计算机断层扫描引导下经皮微波消融治疗鼻咽癌肺转移

Computed tomography-guided percutaneous microwave ablation treatment for lung metastases from nasopharyngeal carcinoma.

作者信息

Qi H, Wan C, Li X, Zhang L, Song Z, Fan W

机构信息

Department of Image-guided Minimally Invasive Therapy, State Key Laboratory of Oncology in South , Sun Yat-Sen University Cancer Center, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.

出版信息

Indian J Cancer. 2015 Dec;52 Suppl 2:e91-5. doi: 10.4103/0019-509X.172521.

Abstract

BACKGROUND

The objective of this retrospective study was to evaluate the safety and efficacy of percutaneous microwave ablation (MWA) for treating lung metastases from nasopharyngeal carcinoma (NPC).

PATIENTS AND METHODS

From December 2012 to November 2014, 17 patients (15 males, and two females, averaged 45.7 years old) with lung metastases from NPC accepted computed tomography (CT)-guided percutaneous MWA. The average number of lung metastases was 1.7 (range: 1-4), and the biggest tumor diameter was 4.2 cm (range: 0.8-4.2 cm). Nineteen nodules located in the right lung and 10 nodules located in the left lung. A total of 29 ablation sites were performed to 29 lung metastases in 22 MWA sessions. Postoperative assessments of complete tumor necrosis rate, safety, local tumor progression, and survival period were carried out.

RESULTS

Of the 29 lesions, complete response was achieved for 27 lesions; residual tumor was found in one lesion 3 months postoperatively; and another lesion was found enlarged 3-month postoperatively with obvious enhancement. Four patients had a small amount of postoperative parenchyma bleeding and two patients had a small amount of pneumothorax. Six months after MWA treatment, new metastatic lesions appeared in six patients, five patients had new metastatic lesions inside the lung, and the other patient had metastatic lesions in the thoracic vertebra. The time for the appearance of new pulmonary metastases for the five patients was 4-20 months, averaged 7.2 months.

CONCLUSION

CT-guided MWA is a promising treatment alternative for local tumor control in selected patients with lung metastases from NPC.

摘要

背景

本回顾性研究的目的是评估经皮微波消融(MWA)治疗鼻咽癌(NPC)肺转移的安全性和有效性。

患者与方法

2012年12月至2014年11月,17例(15例男性,2例女性,平均年龄45.7岁)鼻咽癌肺转移患者接受了计算机断层扫描(CT)引导下的经皮MWA治疗。肺转移灶的平均数量为1.7个(范围:1 - 4个),最大肿瘤直径为4.2 cm(范围:0.8 - 4.2 cm)。19个结节位于右肺,10个结节位于左肺。在22次MWA治疗中,对29个肺转移灶进行了总共29个消融位点的治疗。术后对肿瘤完全坏死率、安全性、局部肿瘤进展和生存期进行了评估。

结果

29个病灶中,27个病灶达到完全缓解;术后3个月在1个病灶中发现残留肿瘤;另1个病灶在术后3个月发现增大且有明显强化。4例患者术后出现少量实质内出血,2例患者出现少量气胸。MWA治疗6个月后,6例患者出现新的转移灶,5例患者肺内出现新的转移灶,另1例患者胸椎出现转移灶。5例患者出现新肺转移灶的时间为4 - 20个月,平均7.2个月。

结论

CT引导下的MWA是治疗部分鼻咽癌肺转移患者局部肿瘤控制的一种有前景的治疗选择。

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