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微波消融与冷冻消融治疗原发性和转移性肺恶性肿瘤的比较

Microwave ablation vs. cryoablation for treatment of primary and metastatic pulmonary malignant tumors.

作者信息

Li Hong-Wei, Long Yong-Jun, Yan Gao-Wu, Bhetuwal Anup, Zhuo Li-Hua, Yao Hong-Chao, Zhang Jie, Zou Xing-Xiong, Hu Pei-Xi, Yang Han-Feng, Du Yong

机构信息

Department of Radiology, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, Sichuan 621000, P.R. China.

Department of Radiology, Suining Central Hospital, Suining, Sichuan 629000, P.R. China.

出版信息

Mol Clin Oncol. 2022 Mar;16(3):62. doi: 10.3892/mco.2022.2495. Epub 2022 Jan 14.

Abstract

At present, minimally invasive surgery is one of the primary strategies for the treatment of malignant pulmonary tumors. Although, there are some comparative studies between microwave ablation and radiofrequency for the treatment of malignant pulmonary tumors, there are few studies that have investigated the comparison between microwave ablation and cryoablation. The aim of the study was to retrospectively compare the efficacy and complications of microwave ablation (MWA) and cryoablation in the treatment of malignant pulmonary tumors. A retrospective analysis was performed on 48 patients with malignant lung tumors treated with MWA or cryoablation in The Third Hospital of Mianyang and The Affiliated Hospital of North Sichuan Medical College between June 2014 and June 2018. Of these patients, 29 received MWA and 19 received cryoablation. Intraprocedural pain was evaluated by using the visual analog scale (VAS). The intraprocedural pain, response rates, overall survival (OS) and complications rates were compared between the MWA group and cryoablation group. The results showed that the patients in the MWA group experienced more pain than those in cryoablation group as the MWA group VAS scores were much higher than those in cryoablation group (P<0.001). The overall response rate of the MWA group [21/29 (72.41%)] was not significantly different from the cryoablation group [14/19 (73.68%)] (P=0.92). The 6-, 12-, 24- and 36-month OS rates in the MWA group and cryoablation group were 92.72, 81.28, 64.54 and 54.91%, and 94.07, 81.13, 57.33 and 43.04%, respectively. No significant differences were found in the OS rate between the two groups (P=0.79). The complication rates in the MWA and cryoablation groups were 34.48 and 36.84%, respectively; there was no significant difference between the two groups (P=0.59). No patients died during the perioperative period. Cryoablation had a similar therapeutic effect compared with MWA in the treatment of pulmonary malignant tumors, but was associated with less pain.

摘要

目前,微创手术是治疗恶性肺肿瘤的主要策略之一。虽然,已有一些关于微波消融和射频消融治疗恶性肺肿瘤的比较研究,但很少有研究对微波消融和冷冻消融进行比较。本研究的目的是回顾性比较微波消融(MWA)和冷冻消融治疗恶性肺肿瘤的疗效及并发症。对2014年6月至2018年6月在绵阳市第三人民医院和川北医学院附属医院接受MWA或冷冻消融治疗的48例恶性肺肿瘤患者进行回顾性分析。其中,29例接受MWA,19例接受冷冻消融。采用视觉模拟量表(VAS)评估术中疼痛。比较MWA组和冷冻消融组的术中疼痛、缓解率、总生存期(OS)和并发症发生率。结果显示,MWA组患者的疼痛程度高于冷冻消融组,因为MWA组的VAS评分远高于冷冻消融组(P<0.001)。MWA组的总缓解率[21/29(72.41%)]与冷冻消融组[14/19(73.68%)]无显著差异(P=0.92)。MWA组和冷冻消融组的6个月、12个月、24个月和36个月OS率分别为92.72%、81.28%、64.54%和54.91%,以及94.07%、81.13%、57.33%和43.04%。两组的OS率无显著差异(P=0.79)。MWA组和冷冻消融组的并发症发生率分别为34.48%和36.84%;两组之间无显著差异(P=0.59)。围手术期无患者死亡。在治疗肺部恶性肿瘤方面,冷冻消融与MWA具有相似的治疗效果,但疼痛较轻。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52d2/8822887/4d5b02ae671f/mco-16-03-02495-g00.jpg

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