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邻近胸膜的肺部恶性肿瘤局部消融:中期局部疗效及安全性评估

Local ablation of pulmonary malignancies abutting pleura: Evaluation of midterm local efficacy and safety.

作者信息

Hu Hong-Tao, Zhao Xiao-Hui, Guo Chen-Yang, Yao Quan-Jun, Geng Xiang, Zhu Wen-Bo, Li Hong-Le, Fan Wei-Jun, Li Hai-Liang

机构信息

Department of Minimal-Invasive Intervention, the Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China.

The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China.

出版信息

Front Oncol. 2022 Aug 22;12:976777. doi: 10.3389/fonc.2022.976777. eCollection 2022.

Abstract

OBJECTIVE

To retrospectively evaluate the efficacy and safety of local ablation treatment for adjacent pleural lung tumors.

MATERIALS AND METHODS

Sixty-two patients who underwent pulmonary nodule ablation at the Affiliated Cancer Hospital of Zhengzhou University were enrolled between January 2016 and December 2020. All patients were followed up with enhanced computed tomography or magnetic resonance imaging within 48 h after treatment and 2, 4, 6, 9, and 12 months after treatment. All patients were followed for at least 12 months.

RESULTS

A total of 84 targeted tumors (62 patients) underwent 94 ablations. In the 12-month follow-up images, 69 of the 84 targeted tumors were completely ablated, 15 had incomplete ablation, and the 12-month incomplete ablation rate was 17.8% (15/84). Of the 15 incompletely ablated tumors, six had partial responses, five had stable disease, and four had progressive disease. The most common adverse event was pneumothorax, with an incidence of 54.8% (34/62). The second most common complication was pleural effusion, with an incidence rate of 41.9% (26/62). The incidence of needle-tract bleeding was 21% (13/62) and all patients were cured using hemostatic drugs. Serious complications were bronchopleural fistula in four patients (6.5%, 4/62) and needle tract metastasis in one patient. Four cases of bronchopleural fistula were found in the early stages and were cured after symptomatic treatment.

CONCLUSION

Local ablation is effective for the treatment of adjacent pleural lung tumors, and its operation is safe and controllable.

摘要

目的

回顾性评估局部消融治疗邻近胸膜肺肿瘤的疗效和安全性。

材料与方法

选取2016年1月至2020年12月在郑州大学附属肿瘤医院接受肺结节消融治疗的62例患者。所有患者在治疗后48小时内以及治疗后2、4、6、9和12个月接受增强计算机断层扫描或磁共振成像随访。所有患者均随访至少12个月。

结果

62例患者共84个靶向肿瘤接受了94次消融治疗。在12个月的随访影像中,84个靶向肿瘤中有69个完全消融,15个消融不完全,12个月的不完全消融率为17.8%(15/84)。15个消融不完全的肿瘤中,6个部分缓解,5个病情稳定,4个病情进展。最常见的不良事件是气胸,发生率为54.8%(34/62)。第二常见的并发症是胸腔积液,发生率为41.9%(26/62)。针道出血发生率为21%(13/62),所有患者使用止血药物后治愈。严重并发症为4例支气管胸膜瘘(6.5%,4/62)和1例针道转移。4例支气管胸膜瘘在早期发现,经对症治疗后治愈。

结论

局部消融治疗邻近胸膜肺肿瘤有效,手术安全可控。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd16/9446881/04e198734501/fonc-12-976777-g001.jpg

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