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CT引导下经皮冷冻消融术用于胃癌肝转移的姑息治疗

CT-guided percutaneous cryoablation for palliative therapy of gastric cancer liver metastases.

作者信息

Chang Xu, Wang Yan, Yu Hai-Peng, Zhang Wei-Hao, Yang Xue-Ling, Guo Zhi

机构信息

Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Huan Hu West Road, Tianjin 300060, PR China.

出版信息

Cryobiology. 2018 Jun;82:43-48. doi: 10.1016/j.cryobiol.2018.04.010. Epub 2018 Apr 19.

Abstract

OBJECTIVE

Liver metastases occur in approximately 4%-14% of gastric cancer patients and are associated with high mortality. However, no standardized treatment approach is available for these patients. We aimed to assess the clinical outcomes of patients with gastric cancer liver metastases (GCLM) who underwent percutaneous cryoablation.

METHODS

We retrospectively enrolled 19 patients with 27 metastatic hepatic tumors who underwent cryoablation for liver metastases after gastrectomy for primary gastric cancer. Complications, overall survival (OS), local tumor progression-free survival (PFS), recurrence rates, and quality of life were assessed.

RESULTS

After cryoablation therapy, the median OS for all 19 patients was 16.0 months (range, 5-50 months), and the 1-, 2-, and 3-year OS rates were 78.9%, 43.4%, and 21.7%, respectively. The median local tumor PFS was 8.0 months (range, 3-24 months), and the local tumor PFS rates at 6 and 12 months were 59.2% and 23.2%, respectively. Overall, patients' quality of life improved after cryoablation therapy (P < 0.05). Complications in this study were mild; no severe complications caused by technique were detected.

CONCLUSIONS

Cryoablation provided good local control, improved patients' quality of life and had a low complication rate. Our research showed that cryoablation may be an effective palliative treatment for GCLM.

摘要

目的

胃癌患者中约4%-14%会发生肝转移,且与高死亡率相关。然而,这些患者尚无标准化的治疗方法。我们旨在评估接受经皮冷冻消融术的胃癌肝转移(GCLM)患者的临床结局。

方法

我们回顾性纳入了19例患有27个转移性肝肿瘤的患者,这些患者在接受原发性胃癌胃切除术后因肝转移接受了冷冻消融术。评估了并发症、总生存期(OS)、局部肿瘤无进展生存期(PFS)、复发率和生活质量。

结果

冷冻消融治疗后,所有19例患者的中位OS为16.0个月(范围5-50个月),1年、2年和3年OS率分别为78.9%、43.4%和21.7%。局部肿瘤的中位PFS为8.0个月(范围3-24个月),6个月和12个月时的局部肿瘤PFS率分别为59.2%和23.2%。总体而言,冷冻消融治疗后患者的生活质量有所改善(P<0.05)。本研究中的并发症较轻;未检测到由技术导致的严重并发症。

结论

冷冻消融提供了良好的局部控制,改善了患者的生活质量,且并发症发生率较低。我们的研究表明,冷冻消融可能是一种治疗GCLM的有效姑息治疗方法。

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