同时立体定向射频消融多个（≥ 4）肝脏肿瘤：可行性、安全性和疗效。
Simultaneous Stereotactic Radiofrequency Ablation of Multiple (≥ 4) Liver Tumors: Feasibility, Safety, and Efficacy.
机构信息
Section of Interventional Oncology-Microinvasive Therapy (SIP), Department of Radiology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck 6020, Austria.
Section of Interventional Oncology-Microinvasive Therapy (SIP), Department of Radiology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck 6020, Austria.
出版信息
J Vasc Interv Radiol. 2020 Jun;31(6):943-952. doi: 10.1016/j.jvir.2019.12.794. Epub 2020 May 12.
PURPOSE
To assess feasibility, safety, and clinical outcome of simultaneous stereotactic radiofrequency (RF) ablation of multiple (≥ 4) primary and metastatic liver tumors.
MATERIALS AND METHODS
This retrospective observational study included 92 patients (29 women, 62 men), 35 with ≥ 4 hepatocellular carcinomas (HCCs) and 57 with ≥ 4 metastatic liver tumors at initial stereotactic RF ablation between 2005 and 2018. The median size of 178 HCCs and 371 metastases was 2.2 cm (range, 1.0-8.5 cm) and 3.0 cm (range, 0.5-13 cm), respectively. At initial stereotactic RF ablation, 17 (48.6%) patients with HCC and 19 (33.3%) with metastases had 4 liver tumors, 11 (31.4%) and 19 (33.3%) had 5 tumors, and 7 (20%) and 19 (33.3%) had ≥ 6 tumors.
RESULTS
Major complications occurred in 2 of 35 ablations (5.4%) in patients with HCCs and in 7 of 63 (10%) with metastases. The primary technical efficacy rate (ie, successful initial ablation) was 100% (178/178) in HCCs and 98.8% (363/371) in metastases. Local recurrence was observed in 4 of 178 (2.2%) HCCs and in 17 of 371 (4.6%) metastases. Overall survival (OS) rates at 1, 3, and 5 years from the date of the first stereotactic RF ablation were 88.0%, 54.0%, and 30.4% for patients with HCCs with a median OS of 38.2 months and 86.1%, 53.1%, and 37.3% for patients with metastases with a median OS of 37.4 months.
CONCLUSIONS
Stereotactic RF ablation is a feasible, safe, and efficacious option in simultaneous management of multiple primary and metastatic liver tumors.
目的
评估同时立体定向射频 (RF) 消融多个（≥4 个）原发性和转移性肝肿瘤的可行性、安全性和临床结果。
材料与方法
本回顾性观察研究纳入了 2005 年至 2018 年间初次立体定向 RF 消融时具有≥4 个原发性肝癌（HCC）和≥4 个转移性肝肿瘤的 92 例患者（女性 29 例，男性 62 例），其中 35 例患者具有≥4 个 HCC，57 例患者具有≥4 个转移性肝肿瘤。178 个 HCC 和 371 个转移灶的中位大小分别为 2.2cm（范围：1.0-8.5cm）和 3.0cm（范围：0.5-13cm）。初次立体定向 RF 消融时，17 例 HCC 患者（48.6%）和 19 例转移性肝肿瘤患者（33.3%）各有 4 个肝脏肿瘤，11 例 HCC 患者（31.4%）和 19 例转移性肝肿瘤患者（33.3%）各有 5 个肿瘤，7 例 HCC 患者（20%）和 19 例转移性肝肿瘤患者（33.3%）各有≥6 个肿瘤。
结果
2 例 HCC 患者（5.4%）和 7 例转移性肝肿瘤患者（10%）发生主要并发症。HCC 患者的初次技术疗效（即初始消融成功）率为 100%（178/178），转移性肝肿瘤患者为 98.8%（363/371）。4 例 HCC 患者（2.2%）和 17 例转移性肝肿瘤患者（4.6%）出现局部复发。初次立体定向 RF 消融后 1、3 和 5 年的 HCC 患者总生存率（OS）分别为 88.0%、54.0%和 30.4%，中位 OS 为 38.2 个月，转移性肝肿瘤患者分别为 86.1%、53.1%和 37.3%，中位 OS 为 37.4 个月。
结论
立体定向 RF 消融是同时治疗多个原发性和转移性肝肿瘤的一种可行、安全且有效的选择。
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