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一项关于影像引导下经皮微波消融治疗原发性和转移性肺恶性肿瘤的单中心研究的安全性和疗效结果

Safety and Efficacy Outcomes From a Single-Center Study of Image-Guided Percutaneous Microwave Ablation for Primary and Metastatic Lung Malignancy.

作者信息

Chan Stephen M, Julien Peter J, Kaganjo Peter, McKenna Robert J, Forscher Charles, Natale Ronald, Wolfe Robert N, Butenschoen Kristi, Siegel Rene J, Mirocha James

机构信息

Cedars-Sinai Medical Center, Los Angeles, California.

Professional Emergency Physicians, Fort Wayne, Indiana.

出版信息

JTO Clin Res Rep. 2022 Dec 28;4(2):100454. doi: 10.1016/j.jtocrr.2022.100454. eCollection 2023 Feb.

Abstract

INTRODUCTION

Image-guided percutaneous microwave ablation (MWA) is becoming a more common treatment option for patients with primary and metastatic lung malignancies. Nevertheless, there is limited literature on the safety and efficacy of MWA compared with standard-of-care therapy, including surgical resection and radiation. This study will report the long-term outcomes after MWA for pulmonary malignancies and investigate the factors related to efficacy, including lesion size, location, and ablation power.

METHODS

Retrospective single-center study analyzing 93 patients who underwent percutaneous MWA for primary or metastatic lung malignancies. Outcomes included immediate technical success, local tumor recurrence, overall survival, disease-specific survival, and complications.

RESULTS

At a single institution, 190 lesions (81 primary and 109 metastatic) were treated in 93 patients. Immediate technical success was achieved in all cases. Freedom from local recurrence was 87.6%, 75.3%, and 69.2% and overall survival was 87.7%, 76.2%, and 74.3% at 1 year, 2 years, and 3 years, respectively. Disease-specific survival was 92.6%, 81.8%, and 81.8%. The most common complication was pneumothorax, which occurred in 54.7% (104 of 190) of procedures, with 35.2% (67 of 190) requiring a chest tube. No life-threatening complications occurred.

CONCLUSIONS

Percutaneous MWA seems safe and effective for treatment of primary and metastatic lung malignancies and should be considered for patients with limited metastatic burden and lesions less than 3 cm in size.

摘要

引言

影像引导下经皮微波消融术(MWA)正成为原发性和转移性肺恶性肿瘤患者更常用的治疗选择。然而,与包括手术切除和放疗在内的标准治疗相比,关于MWA安全性和有效性的文献有限。本研究将报告肺恶性肿瘤MWA后的长期结果,并调查与疗效相关的因素,包括病灶大小、位置和消融功率。

方法

回顾性单中心研究,分析93例行经皮MWA治疗原发性或转移性肺恶性肿瘤的患者。结果包括即刻技术成功、局部肿瘤复发、总生存期、疾病特异性生存期和并发症。

结果

在单一机构,93例患者共治疗了190个病灶(81个原发性和109个转移性)。所有病例均取得即刻技术成功。1年、2年和3年的局部复发率分别为87.6%、75.3%和69.2%,总生存率分别为87.7%、76.2%和74.3%。疾病特异性生存率为92.6%、81.8%和81.8%。最常见的并发症是气胸,发生率为54.7%(190例中的104例),其中35.2%(190例中的67例)需要放置胸管。未发生危及生命的并发症。

结论

经皮MWA治疗原发性和转移性肺恶性肿瘤似乎安全有效,对于转移负担有限且病灶小于3 cm的患者应考虑采用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20a2/9950924/f6c032e35386/gr1.jpg

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