Department of Medical Imaging, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
Faculty of Medicine, The University of Queensland, St Lucia, Brisbane, Queensland, Australia.
J Med Imaging Radiat Oncol. 2020 Dec;64(6):787-793. doi: 10.1111/1754-9485.13091. Epub 2020 Jul 28.
This study aimed to evaluate the long-term outcome of microwave ablation (MWA) of early-stage non-small cell lung cancer (NSCLC), including response to treatment and survival.
This retrospective study was conducted on consecutive patients who underwent computed tomography-guided MWA of early-stage NSCLC (no evidence of nodal or distant metastasis) from November 2010 to December 2014 at our institution. Data were collected from systematic review of patient charts and imaging. Procedural complications, response to treatment and survival were assessed.
34 early-stage (T1a-T3N0M0) NSCLCs in 30 patients were treated with a total of 41 MWA sessions. There were no intraprocedural or 30-day post-procedural deaths. The most common complication was pneumothorax, encountered in 24 (59%) microwave ablation sessions, six (15%) of which required chest tube insertion. Over a median computed tomography follow-up period of 39 months (range 3-89), 24 (71%) NSCLCs demonstrated local control, while 10 (29%) demonstrated local progression. Nodal/distant progression was more common than local progression, with 15 of the 30 patients (50%) having nodal or distant metastases at follow-up. Patient survival status was followed up over a median period of 56.5 months (range 10-107). Median overall survival and 5-year overall survival were 56.5 months (95% confidence interval, 26-not reached) and 46.7% (95% confidence interval, 31.8-68.4), respectively.
MWA is safe and effective at achieving local control of early-stage NSCLC and may prolong patient survival. Nodal or distant metastases were the dominant manifestations of disease progression at long-term follow-up.
本研究旨在评估微波消融（MWA）治疗早期非小细胞肺癌（NSCLC）的长期疗效，包括治疗反应和生存情况。
本回顾性研究纳入 2010 年 11 月至 2014 年 12 月期间在我院接受 CT 引导下 MWA 治疗的早期（无淋巴结或远处转移证据）NSCLC 连续患者。通过系统回顾患者病历和影像学资料收集数据。评估手术并发症、治疗反应和生存情况。
30 例患者共 34 个早期（T1a-T3N0M0）NSCLC 接受了总共 41 次 MWA 治疗。无术中或 30 天内死亡病例。最常见的并发症是气胸，24 次（59%）MWA 治疗中出现气胸，其中 6 次（15%）需要插入胸腔引流管。在中位数为 39 个月（范围 3-89 个月）的 CT 随访期间，24 个（71%）NSCLC 显示局部控制，而 10 个（29%）显示局部进展。淋巴结/远处转移比局部进展更为常见，30 例患者中有 15 例（50%）在随访时出现淋巴结或远处转移。对患者的生存状况进行了中位数为 56.5 个月（范围 10-107 个月）的随访。中位总生存期和 5 年总生存率分别为 56.5 个月（95%置信区间，26-未达到）和 46.7%（95%置信区间，31.8-68.4）。
MWA 治疗早期 NSCLC 安全有效，可实现局部控制并延长患者生存时间。在长期随访中，淋巴结或远处转移是疾病进展的主要表现。
