Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, 250021, Shandong Province, China.
Department of Oncology, Shandong Lung Cancer Institute, Shandong Provincial Qianfoshan Hospital, The First Affiliated Hospital of Shandong First Medical University, 16766 Jingshi Road, Jinan, 250014, Shandong Province, China.
Eur Radiol. 2022 Aug;32(8):5616-5622. doi: 10.1007/s00330-022-08615-8. Epub 2022 Feb 28.
In the present study, we aim to show the results of microwave ablation (MWA) for medically inoperable stage I non-small cell lung cancers (NSCLCs) with long-term follow-up.
From Feb 2011 to Mar 2016, patients with histologically proven clinical stage I NSCLC were treated with CT-guided MWA and retrospectively analyzed. The primary end point was overall survival (OS). Secondary end points included disease-free survival (DFS), cancer-specific survival (CSS), and complications.
A total of 105 patients with 105 lesions underwent MWA. The mean age was 70.7 years (range: 40-86 years), and the mean diameter of all lesions was 2.40 cm (range: 0.9-4.0 cm). Adenocarcinoma was the most common histological type (77, 73.3%), followed by squamous cell carcinomas (21, 20%) and undefined NSCLC (7, 6.7%). With a median follow-up of 54.8 months, the median DFS was 36.0 months, and 1-, 3-, and 5-year DFS rates were 89.5%, 49.4%, and 42.7%, respectively. The median CSS and OS were 89.8 and 64.2 months, respectively. The OS rate was 99% at 1 year, 75.6% at 3 years, and 54.1% at 5 years, while the CSS rates were 99%, 78.9%, and 60.9%, respectively. Patients with stage IB lesions had significant shorter DFS (22.3 months vs. undefined, HR: 11.5, 95%CI: 5.85-22.40) and OS (37.3 vs. 89.8 months, HR: 8.64, 95% CI: 4.49-16.60) than IA disease.
MWA is a safe, effective, and potentially curative therapy for medically inoperable stage I NSCLC patients.
• In this multicenter retrospective study which included 105 patients, we found the median overall survival (OS) was 64.2 months. The OS rate was 99% at 1 year, 75.6% at 3 years, and 54.1% at 5 years. • Procedures were technically successful and well tolerated in all patients. Most MWA complications were mild or moderate.
本研究旨在展示长期随访下 CT 引导下微波消融（MWA）治疗无法手术的 I 期非小细胞肺癌（NSCLC）的结果。
自 2011 年 2 月至 2016 年 3 月，对经组织学证实的临床 I 期 NSCLC 患者行 CT 引导下 MWA 治疗，并进行回顾性分析。主要终点为总生存期（OS）。次要终点包括无病生存期（DFS）、癌症特异性生存期（CSS）和并发症。
共 105 例 105 处病灶患者行 MWA 治疗。平均年龄为 70.7 岁（范围：40-86 岁），所有病灶的平均直径为 2.40cm（范围：0.9-4.0cm）。最常见的组织学类型是腺癌（77 例，73.3%），其次是鳞状细胞癌（21 例，20%）和未明确的 NSCLC（7 例，6.7%）。中位随访 54.8 个月时，中位 DFS 为 36.0 个月，1、3 和 5 年 DFS 率分别为 89.5%、49.4%和 42.7%。中位 CSS 和 OS 分别为 89.8 和 64.2 个月。OS 率在 1 年时为 99%，在 3 年时为 75.6%，在 5 年时为 54.1%，而 CSS 率分别为 99%、78.9%和 60.9%。IB 期病变患者的 DFS（22.3 个月比未明确的 36.0 个月，HR：11.5，95%CI：5.85-22.40）和 OS（37.3 个月比 89.8 个月，HR：8.64，95%CI：4.49-16.60）显著更短。
MWA 是治疗无法手术的 I 期 NSCLC 患者的一种安全、有效、有潜在治愈作用的治疗方法。
在这项包含 105 例患者的多中心回顾性研究中，我们发现中位总生存期（OS）为 64.2 个月。OS 率在 1 年时为 99%，在 3 年时为 75.6%，在 5 年时为 54.1%。
所有患者的手术均技术成功，且均能良好耐受。大多数 MWA 并发症为轻度或中度。
