Department of Medical Imaging, CHU Montpellier-Lapeyronie, 371 Avenue du Doyen Gaston-Giraud, 34295 Montpellier cedex 5, France.
Department of Medical Imaging, Hôpital Saint-Jean, 66000 Perpignan, France.
Diagn Interv Imaging. 2019 Dec;100(12):781-791. doi: 10.1016/j.diii.2019.07.008. Epub 2019 Aug 8.
The purpose of this study was to retrospectively compare microwave (MWA) and radiofrequency (RFA) ablation in the percutaneous treatment of primary and secondary lung tumors.
A total of 115 patients with a total of 160 lung tumors (primary, n=41; secondary, n=119) were retrospectively included. There were 56 men and 59 women with a mean age of 67.8±12.7 (SD) years (range: 42-89 years) who underwent either MWA (61 patients; 79 tumors) or RFA (54 patients; 81 tumors). The primary study endpoints were local recurrence during follow-up and the incidence of complications during and following thermal ablation. The MWA and RFA groups were compared in terms of treatment efficacy and complication rates.
Demographics were similar in the two groups. Mean tumor diameter was smaller in RFA group (13.1±5.1 [SD] mm; range: 4-27mm) than in MWA group (17.1±8.3 [SD] mm; range: 5-36mm) (P<0.001). Ablation volumes at one month were 24.1±21.7 (SD) cm (range: 2-97.8 cm) in RFA group and 30.2±35.9 (SD) cm (range: 1.9-243.8 cm) in MWA group (P=0.195). During a mean overall follow-up duration of 488±407 (SD) days (range: 30-1508 days), 9/160 tumors (5.6%) developed local recurrence: six (6/79; 7.6%) in the RFA group and three (3/81; 3.7%) in the MWA group (P=0.32). Pneumothoraces were more frequent in the RFA group (32/79; 40.5%) than in the MWA group (20/81; 24.7%) (P=0.049). The mean length of hospital stay was 4.5±3.7 (SD) days (range: 1-25 days) in the RFA group and 4.7±4.6 (SD) days (range: 2-25 days) in the MWA group (P=0.76).
MWA favorably compares with RFA and can be considered as an effective and safe thermal ablation technique for lung tumors, especially in situations where RFA has limited efficacy.
本研究旨在回顾性比较微波（MWA）和射频（RFA）消融在原发性和继发性肺肿瘤经皮治疗中的应用。
共纳入 115 例共 160 个肺肿瘤患者（原发性 41 例，继发性 119 例）。其中男 56 例，女 59 例，平均年龄 67.8±12.7（SD）岁（范围：42-89 岁），分别行 MWA（61 例，79 个肿瘤）或 RFA（54 例，81 个肿瘤）治疗。主要研究终点为随访期间的局部复发率和热消融治疗期间及之后的并发症发生率。比较 MWA 和 RFA 两组的治疗效果和并发症发生率。
两组患者的一般资料相似。RFA 组的肿瘤平均直径明显小于 MWA 组（13.1±5.1[SD]mm；范围：4-27mm）（P<0.001）。RFA 组的消融体积在 1 个月时为 24.1±21.7（SD）cm（范围：2-97.8cm），MWA 组为 30.2±35.9（SD）cm（范围：1.9-243.8cm）（P=0.195）。在平均 488±407（SD）天（范围：30-1508 天）的总随访期间，160 个肿瘤中有 9 个（5.6%）发生局部复发：RFA 组 6 个（7.6%），MWA 组 3 个（3.7%）（P=0.32）。RFA 组的气胸发生率明显高于 MWA 组（32/79；40.5%）（P=0.049）。RFA 组的平均住院时间为 4.5±3.7（SD）天（范围：1-25 天），MWA 组为 4.7±4.6（SD）天（范围：2-25 天）（P=0.76）。
MWA 与 RFA 相比具有优势，可作为治疗肺肿瘤的有效且安全的热消融技术，尤其适用于 RFA 疗效有限的情况。
