Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwuweiqi Road, Jinan, 250021, Shandong, China.
J Cancer Res Clin Oncol. 2020 May;146(5):1361-1367. doi: 10.1007/s00432-020-03176-z. Epub 2020 Mar 7.
Local therapy including surgery or radiotherapy has been reported for the treatment of non-small cell lung cancer (NSCLC) with synchronous solitary metastasis, while studies with other local ablative treatment are rare. Here, we summarized our single-center experience of microwave ablation (MWA) for both primary and metastatic lesions in NSCLC patients with synchronous solitary extracranial metastases.
We retrospectively screened our institute database from January 2014 to Jun 2019. NSCLC patients with synchronous extracranial solitary metastasis with primary and metastatic lesions that were treated with MWA were identified and analyzed.
Of the 1472 stage IV NSCLC patients found, 38 were diagnosed with synchronous extracranial solitary metastasis and 29 of them received MWA for primary and metastatic lesions. The most common distant metastases were contralateral lung metastases (14 cases), followed by bone (6), liver (4), adrenal gland (3) and pleura metastases (1). Median OS and PFS was 21.5 and 12.5 months, respectively. Patients with N0 had significantly longer PFS (median 18.5 vs. 8.0 months) and OS (median 42.7 vs. 19.0 months). In addition, systemic therapy was showed to be a prognostic factor for better PFS (12.9 vs. 7.5 months). Clinical pathological factors including age, histology, T stage, PS score, and metastasis locations are not significantly associated with survival.
MWA may serve as an alternative treatment for NSCLCs with synchronous solitary extracranial metastases.
局部治疗，包括手术或放疗，已被报道用于治疗同时性孤立性转移的非小细胞肺癌（NSCLC），而其他局部消融治疗的研究则很少。在这里，我们总结了我们单中心对同时性颅外单发转移的 NSCLC 患者采用微波消融（MWA）治疗原发性和转移性病变的经验。
我们回顾性筛选了 2014 年 1 月至 2019 年 6 月我院的数据库。确定并分析了同时性颅外单发转移且接受 MWA 治疗原发性和转移性病变的 NSCLC 患者。
在 1472 例 IV 期 NSCLC 患者中，有 38 例被诊断为同时性颅外单发转移，其中 29 例接受了 MWA 治疗原发性和转移性病变。最常见的远处转移是对侧肺转移（14 例），其次是骨转移（6 例）、肝转移（4 例）、肾上腺转移（3 例）和胸膜转移（1 例）。中位 OS 和 PFS 分别为 21.5 个月和 12.5 个月。N0 患者的 PFS（中位 18.5 个月比 8.0 个月）和 OS（中位 42.7 个月比 19.0 个月）显著更长。此外，全身治疗显示是更好的 PFS（12.9 个月比 7.5 个月）的预后因素。临床病理因素包括年龄、组织学、T 分期、PS 评分和转移部位与生存无关。
MWA 可能是治疗同时性孤立性颅外转移的 NSCLC 的一种替代治疗方法。
