微波与射频消融治疗结直肠癌肺转移的对比研究。
Comparison of Microwave and Radiofrequency Ablation in the Treatment of Pulmonary Metastasis of Colorectal Cancer.
机构信息
Department of Surgery, St George Hospital, Sydney, NSW, Australia;
St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia.
出版信息
Anticancer Res. 2022 Sep;42(9):4563-4571. doi: 10.21873/anticanres.15959.
BACKGROUND/AIM: Radiofrequency ablation (RFA) for colorectal cancer pulmonary metastases (CRCPulM) has been shown to be safe. Microwave ablation (MWA) has emerged in the treatment for CRCPulM. However, short to long-term efficacy of both modalities have yet to be understood.
PATIENTS AND METHODS
This is a retrospective study of 203 patients who received RFA and MWA from 2000-2018 at a major tertiary hospital in Australia.
RESULTS
A total of 161 patients underwent RFA and 42 MWA. Median ablation size and time was 4 (range=3-5 cm) vs. 3.5 cm (range=3-4 cm; p=0.0395) and 49 (range=26-65 min) vs. 8 min (5-13 min) in the RFA and MWA groups, respectively (p<0.001). The complication rate was 112 (55%) and 40 (74%) in the RFA and MWA group, respectively (p=0.011). Life-threatening pulmonary haemorrhage occurred in 1 (0.5%) and 4 (7.4%) patients in the RFA and MWA group, respectively (p=0.007). Local recurrences detected after discharge were similar in both groups [28% (p<0.001)]. However, the MWA group demonstrated higher survival rate and less recurrence rate than RFA in the first 24 months of follow up.
CONCLUSION
RFA and MWA are competitive treatment methods for CRCPulM. Although MWA has significantly higher complication rate than RFA, it can be performed in a much shorter time and lead to a shorter length of hospital stay.
背景/目的：射频消融（RFA）治疗结直肠癌肺转移（CRCPulM）已被证明是安全的。微波消融（MWA）已在 CRCPulM 的治疗中崭露头角。然而，两种方法的短期至长期疗效仍有待了解。
患者和方法
这是一项回顾性研究，纳入了 2000 年至 2018 年在澳大利亚一家主要三级医院接受 RFA 和 MWA 治疗的 203 例患者。
结果
共有 161 例患者接受 RFA 治疗，42 例患者接受 MWA 治疗。RFA 和 MWA 组的消融大小和时间中位数分别为 4cm（范围 3-5cm）和 3.5cm（范围 3-4cm；p=0.0395）和 49min（范围 26-65min）和 8min（5-13min）（p<0.001）。RFA 和 MWA 组的并发症发生率分别为 112 例（55%）和 40 例（74%）（p=0.011）。RFA 和 MWA 组分别有 1 例（0.5%）和 4 例（7.4%）患者发生危及生命的肺出血（p=0.007）。出院后发现局部复发率在两组间相似[28%（p<0.001）]。然而，在随访的前 24 个月，MWA 组的生存率更高，复发率更低。
结论
RFA 和 MWA 是治疗 CRCPulM 的两种竞争方法。尽管 MWA 的并发症发生率明显高于 RFA，但它可以在更短的时间内完成，并且导致更短的住院时间。
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