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射频消融与微波消融治疗肺肿瘤:LUMIRA(肺微波射频)随机试验

Radiofrequency versus microwave ablation for treatment of the lung tumours: LUMIRA (lung microwave radiofrequency) randomized trial.

作者信息

Macchi M, Belfiore M P, Floridi C, Serra N, Belfiore G, Carmignani L, Grasso R F, Mazza E, Pusceddu C, Brunese L, Carrafiello G

机构信息

Department of Radiology, Circolo e Fondazione Macchi Hospital, Insubria University, Varese, Italy.

Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.

出版信息

Med Oncol. 2017 May;34(5):96. doi: 10.1007/s12032-017-0946-x. Epub 2017 Apr 18.

Abstract

The LUMIRA trial evaluated the effectiveness of radiofrequency (RFA) and microwave ablation (MWA) in lung tumours ablation and defining more precisely their fields of application. It is a controlled prospective multi-centre random trial with 1:1 randomization. Fifty-two patients in stage IV disease (15 females and 37 males, mean age 69 y.o., range 40-87) were included. We randomized the patients in two different subgroups: MWA group and RFA group. For each group, we evaluated the technical and clinical success, the overall survival and complication rate. Inter-group difference was compared using Chi-square test or Fisher's exact test for categorical variables and one-way ANOVA test for continuous variables. For RFA group, there was a significant reduction in tumour size only between 6 and 12 months (p value = 0.0014). For MWA group, there was a significant reduction in tumour size between 6 and 12 months (p value = 0.0003) and between pre-therapy and 12 months (p value = 0.0215). There were not significant differences between the two groups in terms of survival time (p value = 0.883), while the pain level in MWA group was significantly less than in RFA group (1.79 < 3.25, p value = 0.0043). In conclusion, our trial confirms RFA and MWA are both excellent choices in terms of efficacy and safety in lung tumour treatments. However, when compared to RFA therapy, MWA produced a less intraprocedural pain and a significant reduction in tumour mass.

摘要

LUMIRA试验评估了射频消融(RFA)和微波消融(MWA)在肺肿瘤消融中的有效性,并更精确地界定了它们的应用领域。这是一项前瞻性多中心对照随机试验,随机比例为1:1。纳入了52例IV期患者(15例女性和37例男性,平均年龄69岁,范围40 - 87岁)。我们将患者随机分为两个不同亚组:MWA组和RFA组。对于每组,我们评估了技术和临床成功率、总生存率和并发症发生率。对于分类变量,使用卡方检验或Fisher精确检验比较组间差异;对于连续变量,使用单因素方差分析检验。对于RFA组,仅在6至12个月之间肿瘤大小有显著减小(p值 = 0.0014)。对于MWA组,在6至12个月之间(p值 = 0.0003)以及治疗前至12个月之间(p值 = 0.0215)肿瘤大小有显著减小。两组在生存时间方面无显著差异(p值 = 0.883),而MWA组的疼痛程度显著低于RFA组(1.79 < 3.25,p值 = 0.0043)。总之,我们的试验证实RFA和MWA在肺肿瘤治疗的疗效和安全性方面都是很好的选择。然而,与RFA治疗相比,MWA产生的术中疼痛较轻,肿瘤体积显著减小。

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