Ferguson Craig D, Luis Chris R, Steinke Karin
Department of Medical Imaging, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
J Med Imaging Radiat Oncol. 2017 Apr;61(2):243-249. doi: 10.1111/1754-9485.12600. Epub 2017 Mar 7.
To evaluate the safety and therapeutic efficacy of percutaneous microwave ablation (MWA) for colorectal pulmonary metastases.
Retrospective review of CT-guided lung MWA at a single tertiary institution. Adverse events within 30 days of MWA were considered procedure-related complications. Imaging follow-up was with 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT and contrast-enhanced CT. Response of index tumours was assessed using modified response evaluation criteria in solid tumours (mRECIST).
The CT-guided lung MWA was performed in 14 patients with treatment of 20 colorectal pulmonary metastases during 19 procedures. Mean follow-up from completion of the treatment protocol was 24.4 ± 11.8 months. Primary and secondary technique effectiveness rates were 75% and 50% respectively. Mean pre- and post-procedural carcino-embryonic antigen (CEA) levels were 7.9 ± 10.8 µg/L and 2.5 ± 2.1 µg/L respectively. Procedure-related complications were major in three procedures (15.8%) and minor in six procedures (31.6%). No procedure-related deaths occurred.
Microwave ablation is safe and efficacious in the local control of colorectal pulmonary metastases. The frequent systemic disease progression despite local control would favour a minimally invasive treatment option over invasive surgery in the setting of oligometastatic disease.
评估经皮微波消融（MWA）治疗结直肠癌肺转移的安全性和疗效。
对一家三级医疗机构的CT引导下肺MWA进行回顾性研究。将MWA后30天内的不良事件视为与手术相关的并发症。影像学随访采用18F-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）/CT和增强CT。采用实体瘤改良反应评估标准（mRECIST）评估靶肿瘤的反应。
14例患者接受了CT引导下肺MWA，共进行19次手术，治疗20处结直肠癌肺转移灶。从完成治疗方案开始的平均随访时间为24.4±11.8个月。初次和二次技术有效率分别为75%和50%。术前和术后癌胚抗原（CEA）平均水平分别为7.9±10.8μg/L和2.5±2.1μg/L。与手术相关的并发症中，3例（15.8%）为严重并发症，6例（31.6%）为轻微并发症。未发生与手术相关的死亡。
微波消融在局部控制结直肠癌肺转移方面安全有效。尽管能实现局部控制，但频繁出现的全身疾病进展表明，对于寡转移疾病，微创治疗方案优于侵入性手术。
