Department of Interventional Medicine, The Second Hospital of Shandong University, Jinan, PR China.
Interventional Oncology Institute of Shandong University, Jinan, China.
Thorac Cancer. 2020 Mar;11(3):697-703. doi: 10.1111/1759-7714.13320. Epub 2020 Jan 29.
Salvage treatments for recurrent NSCLC after first-line chemotherapy remain challenging. This study was conducted to evaluate the clinical value of microwave ablation (MWA) and iodine-125 brachytherapy, including overall survival (OS), disease free survival (DFS), local control, hospital stay, and health economics.
The data of 51 and 32 patients who were treated with MWA and brachytherapy was retrospectively analyzed. The number of lesions was limited up to two, with a diameter <4 cm and patients diagnosed with unilateral lung disease. Peripheral tumors were treated with MWA, while lesions close to the hilum were treated with brachytherapy. Contrast-enhanced CT, blood cell count, coagulation function, liver & kidney function and tumor markers were performed for two years, with complications calculated. OS, DFS, local control rate, toxicity, hospital stay and expense were recorded.
The one and two-year OS rates were 96.08% and 92.16% versus 96.88% and 90.62% in the MWA and brachytherapy groups, respectively. The one and two-year DFS rates were 92.16% and 76.47% versus 93.75% and 78.13%, respectively. No significant differences were observed in log-rank analysis between the groups. Local control rates at six and 12 months were 100% and 96.08% versus 100% and 96.88%, while incidences of pleural effusion were 3.92% and 3.13%, respectively (P < 0.05). Medical cost was 3356.73 ± 206.87 and 6714.28 ± 35.43 U.S. dollars (P = 0.014).
MWA and brachytherapy are effective and safe options for the treatment of NSCLC recurrence after first-line chemotherapy. Which modality should be considered is dependent upon tumor location, tumor size and experience of specialists.
一线化疗后复发性非小细胞肺癌的挽救治疗仍然具有挑战性。本研究旨在评估微波消融（MWA）和碘 125 近距离放疗的临床价值，包括总生存期（OS）、无疾病生存期（DFS）、局部控制率、住院时间和健康经济学。
回顾性分析了 51 例和 32 例接受 MWA 和近距离放疗治疗的患者数据。病变数量限制在两个以内，直径<4cm，单侧肺部疾病。外周肿瘤采用 MWA 治疗，靠近肺门的病变采用近距离放疗。术后两年内进行增强 CT、血细胞计数、凝血功能、肝肾功能和肿瘤标志物检查，计算并发症。记录 OS、DFS、局部控制率、毒性、住院时间和费用。
MWA 和近距离放疗组的 1 年和 2 年 OS 率分别为 96.08%和 92.16%，96.88%和 90.62%；1 年和 2 年 DFS 率分别为 92.16%和 76.47%，93.75%和 78.13%。两组间对数秩分析无显著差异。6 个月和 12 个月时的局部控制率分别为 100%和 96.08%，100%和 96.88%，胸腔积液发生率分别为 3.92%和 3.13%（P<0.05）。医疗费用分别为 3356.73±206.87 和 6714.28±35.43 美元（P=0.014）。
MWA 和近距离放疗是一线化疗后复发性非小细胞肺癌的有效且安全的治疗选择。应根据肿瘤位置、肿瘤大小和专家经验选择哪种治疗方式。
