原发性和继发性肺肿瘤治疗中热消融技术的对比分析：单中心经验。
A comparative analysis of thermal ablation techniques in the treatment of primary and secondary lung tumors: a single-center experience.
机构信息
Departmental Faculty of Medicine and Surgery, Unit of Interventional Radiology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 21, 00128, Rome, Italy.
出版信息
Radiol Med. 2022 Jul;127(7):714-724. doi: 10.1007/s11547-022-01508-2. Epub 2022 Jun 14.
PURPOSE
To evaluate efficacy and safety of radiofrequency ablation (RFA) and microwave ablation (MWA) in unresectable lung malignancies.
METHODS
Data regarding patients with primary and secondary lung tumors treated with RFA or MWA from 2008 to 2020 were reviewed retrospectively. Primary study objectives such as technical success, primary and secondary technique efficacy rates, local tumor progression (LTP) rate, LPT-free survival (LPTFS) and overall survival (OS) were assessed. Secondary study objectives were side effects and complications. RFA and MWA were compared using the Chi-square test for continuous variables. Kaplan-Meier curves were calculated for survival statistical analysis.
RESULTS
A total of 113 patients with primary or secondary lung tumor underwent 74 RFA (48%) and 81 MWA (52%). Technical success rate was 151/155 (97%); primary and secondary technique efficacy rates were 123/155 (79%) and 129/155 (83%), respectively. During the entire study follow-up, 32 cases experienced disease progression (20%), of which 18 underwent repeat ablation (12%), in 6 cases with success (4%). Residual unablated tumor happened in 4/155 cases (3%). LTP occurred in 28/155 cases (17%). The only factor associated with poorer LTP-FS was lesion diameter ≥ 30 mm (P < 0.05). One-, 3- and 5-years LTP-FS was 83%, 82%, 82%, respectively. One-, 3- and 5-years OS of the entire population was 87%, 74%, 73%, respectively. Minor and major complication rates were 53/155 (34%) and 29/155 (19%), respectively.
CONCLUSIONS
In conclusion, this study confirms the appropriateness of RFA and MWA for lung tumors treatment, in terms of safety and efficacy.
目的
评估射频消融（RFA）和微波消融（MWA）治疗不可切除肺部恶性肿瘤的疗效和安全性。
方法
回顾性分析了 2008 年至 2020 年间接受 RFA 或 MWA 治疗的原发性和继发性肺肿瘤患者的数据。主要研究目标包括技术成功率、主要和次要技术疗效率、局部肿瘤进展（LTP）率、LTP 无进展生存期（LTPFS）和总生存期（OS）。次要研究目标为副作用和并发症。采用卡方检验比较 RFA 和 MWA 之间的差异。采用 Kaplan-Meier 曲线进行生存统计分析。
结果
共 113 例原发性或继发性肺肿瘤患者行 74 例 RFA（48%）和 81 例 MWA（52%）。技术成功率为 151/155（97%）；主要和次要技术疗效率分别为 123/155（79%）和 129/155（83%）。在整个研究随访期间，32 例患者发生疾病进展（20%），其中 18 例（12%）接受了重复消融，6 例（4%）成功。在 155 例患者中有 4 例（3%）出现残留未消融肿瘤。28 例（17%）发生 LTP。唯一与较差 LTPFS 相关的因素是病变直径≥30mm（P<0.05）。1、3、5 年 LTPFS 分别为 83%、82%、82%。全人群 1、3、5 年 OS 分别为 87%、74%、73%。轻微和严重并发症发生率分别为 53/155（34%）和 29/155（19%）。
结论
总之，这项研究证实了 RFA 和 MWA 治疗肺部肿瘤在安全性和疗效方面是合适的。
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