Department of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
Department of Radiology, Okayama University Hospital, Okayama, Japan.
Jpn J Radiol. 2022 Oct;40(10):1024-1034. doi: 10.1007/s11604-022-01302-0. Epub 2022 Jul 2.
The aim of this review was to summarize the latest evidence on image-guided thermal ablation therapies for lung metastases. PubMed was used to search for relevant articles that reported the oncological outcomes of thermal ablation for metastatic lung tumors, and those published in 2010 or later were selected for review. Ablative therapies were applied for lung metastases from various types of primary tumors, but most commonly colorectal ones. Radiofrequency ablation (RFA) was the most evaluated technique, followed by microwave ablation (MWA). The local control rates of ablative therapies were generally favorable, approximately 80-90% in many studies. Representative studies demonstrated promising overall survival rates of approximately 50% or higher 5 years after ablation for lung metastases from colorectal cancer or mixed types of primary tumors. Nevertheless, the survival outcomes varied depending on the type of primary tumor and background factors of patients such as other metastases and comorbidities. Several studies had aimed to compare the outcomes of various ablative therapies such as RFA, MWA, and cryoablation; however, conclusive data are not yet available to determine the most appropriate ablation modality for lung metastases. Further data accumulation is needed, especially for long-term outcomes and comparisons with other therapies.
本次综述旨在总结最新的影像引导热消融治疗肺转移瘤的证据。我们使用 PubMed 检索了报告热消融治疗转移性肺肿瘤的肿瘤学结果的相关文章,并选择了 2010 年或以后发表的文章进行综述。消融治疗适用于来自各种类型的原发性肿瘤的肺转移瘤,但最常见的是结直肠癌。射频消融 (RFA) 是评估最多的技术,其次是微波消融 (MWA)。许多研究表明,消融治疗的局部控制率通常较好,约为 80-90%。代表性研究表明,对于结直肠癌或混合类型原发性肿瘤的肺转移瘤,消融治疗后 5 年的总生存率约为 50%或更高。然而,生存结果因原发性肿瘤的类型以及患者的其他转移和合并症等背景因素而异。一些研究旨在比较 RFA、MWA 和冷冻消融等各种消融治疗的结果;然而,尚无确定最适合肺转移瘤的消融方式的明确数据。需要进一步积累数据,特别是关于长期结果和与其他治疗方法的比较。