Ierardi Anna Maria, Coppola Andrea, Lucchina Natalie, Carrafiello Gianpaolo
Department of Radiology, Interventional Radiology, Insubria University, Viale Borri, 57, 21100, Varese, VA, Italy.
Department of Health Sciences, Diagnostic and Interventional Radiology, San Paolo Hospital, University of Milan, Via A di Rudinì 8, 20142, Milan, Italy.
Med Oncol. 2017 Jan;34(1):5. doi: 10.1007/s12032-016-0861-6. Epub 2016 Nov 30.
The purpose of our study is to report safety, technical success, effectiveness, local progression-free survival (LPFS) and overall survival of percutaneous microwave ablation (MWA) to treat lung tumours unsuitable for surgery. Nineteen patients with thirty-one tumours (mean diameter 2.4 cm) underwent percutaneous MWA in 28 sessions. Microwave ablation was carried out using a 2450-MHz generator (Emprint/Covidien, Boulder, CO, USA). Procedures were performed under cone-beam CT (CBCT) and under fluoro-CT (one session) guidance. Safety, technical success, effectiveness, LPFS and overall survival (OS) were evaluated. Safety was defined as the frequency of major and minor complications. The efficacy was evaluated on the basis of imaging characteristics, using RECIST criteria. CT follow-up was performed at 1, 3 and 6 months and yearly. LPFS was defined as the interval between MWA treatment and evidence of local recurrence, if there was any. OS was defined as the percentage of patients who were still alive. We registered one major complication (purulent hydro-pneumothorax). Minor complications were spontaneously resolved (pneumothorax and perilesional haemorrhagic effusion). Technical success was 100%. Residual disease was registered in two cases, one of whom was retreated. Complete ablation was obtained in the remaining cases (90.3%). During available follow-up (mean 9.6 months), 9/31 tumours demonstrated local recurrence. Five tumours were retreated, and none of them presented residual disease during follow-up (LPFS 22.6%). Overall survival was 93.8%. Percutaneous high-energy MWA is a safe, effective and confident technique to treat lung tumours not suitable for surgery.
我们研究的目的是报告经皮微波消融（MWA）治疗不适合手术的肺部肿瘤的安全性、技术成功率、有效性、局部无进展生存期（LPFS）和总生存期。19例患者的31个肿瘤（平均直径2.4厘米）接受了28次经皮MWA治疗。使用2450兆赫发生器（Emprint/Covidien，美国科罗拉多州博尔德）进行微波消融。手术在锥形束CT（CBCT）和荧光透视CT（1次手术）引导下进行。评估安全性、技术成功率、有效性、LPFS和总生存期（OS）。安全性定义为主要和次要并发症的发生率。根据影像学特征，采用RECIST标准评估疗效。在1、3和6个月以及每年进行CT随访。LPFS定义为MWA治疗与局部复发证据（如有）之间的间隔。OS定义为仍存活患者的百分比。我们记录了1例主要并发症（脓性液气胸）。次要并发症自行缓解（气胸和病灶周围出血性积液）。技术成功率为100%。2例出现残留病灶，其中1例再次治疗。其余病例（90.3%）实现完全消融。在可用的随访期间（平均9.6个月），31个肿瘤中有9个出现局部复发。5个肿瘤再次治疗，随访期间均无残留病灶（LPFS为22.6%）。总生存期为93.8%。经皮高能MWA是一种治疗不适合手术的肺部肿瘤的安全、有效且可靠的技术。
