Department of Radiology, Faculty of Medicine, Lokman Hekim University, Ankara, Turkey.
Department of Radiology, Ankara Etlik City Hospital, Ankara, Turkey.
Acta Radiol. 2023 Aug;64(8):2416-2423. doi: 10.1177/02841851231175657. Epub 2023 May 28.
In recent years, many studies have proven that percutaneous thermal ablation is an effective second-line treatment method with low complication rates in early-stage non-small cell lung carcinoma and lung metastases. Radiofrequency ablation and microwave ablation are commonly used for this purpose.
To evaluate the factors affecting the success of the percutaneous thermal ablation treatment with technical success, complication rates, and long-term follow-up results in metastatic lung lesions.
Computed tomography (CT)-guided percutaneous ablation was performed for 70 metastatic lung lesions in 35 patients (22 men, 13 women; mean age = 61.34 years; age range = 41-75 years). Radiofrequency ablation was performed in 53/70 (75.7%) lesions and microwave ablation in 17/70 (24.3%) lesions.
The technical success rate was 98.6%. Median overall survival, progression-free survival, and local recurrence-free survival of the patients were 33.9 months (range=25.6-42.1 months), 12 months (range=4.9-19.2 months), and 24.2 months (range=8.2-40.1 months), respectively. One- and two-year overall survival rates were 84% and 74%, respectively. Median progression-free survival times were 20.3 months and 11.4 months, respectively, according to the number of metastatic lung lesions being single and multiple, and the difference was statistically significant ( = 0.046). According to the number of lesions ≤3 and >3, the difference was also found statistically significant ( = 0.024) (14.3 months and 5.7 months, respectively).
In conclusion, CT-guided percutaneous thermal ablation is a safe and effective treatment method in metastatic lung lesions. The number of lesions is the most important factor in predicting treatment success.
近年来,大量研究证实,经皮热消融术是一种有效且并发症发生率低的二线治疗方法,适用于早期非小细胞肺癌和肺转移瘤。射频消融和微波消融是目前常用的消融技术。
评估经皮热消融治疗转移性肺病变的技术成功率、并发症发生率和长期随访结果的影响因素。
对 35 例(22 例男性,13 例女性;平均年龄 61.34 岁;年龄范围 41-75 岁)患者的 70 个转移性肺病变进行 CT 引导下经皮消融。53/70(75.7%)个病变采用射频消融,17/70(24.3%)个病变采用微波消融。
技术成功率为 98.6%。患者的中位总生存期、无进展生存期和局部无复发生存期分别为 33.9 个月(范围 25.6-42.1 个月)、12 个月(范围 4.9-19.2 个月)和 24.2 个月(范围 8.2-40.1 个月)。1 年和 2 年总生存率分别为 84%和 74%。根据转移性肺病变的数量(单发和多发),中位无进展生存时间分别为 20.3 个月和 11.4 个月,差异具有统计学意义( = 0.046)。根据病变数量(≤3 和>3),差异也具有统计学意义( = 0.024)(分别为 14.3 个月和 5.7 个月)。
总之,CT 引导下经皮热消融术是治疗转移性肺病变的一种安全有效的方法。病变数量是预测治疗成功的最重要因素。