微波消融治疗结直肠肺转移瘤的系统评价
A Systematic Review of Microwave Ablation for Colorectal Pulmonary Metastases.
机构信息
Department of Surgery, St George Hospital, Sydney, NSW, Australia;
Faculty of Medicine, Department of Surgery, University of New South Wales, Sydney, NSW, Australia.
出版信息
Anticancer Res. 2023 Jul;43(7):2899-2907. doi: 10.21873/anticanres.16461.
BACKGROUND/AIM: Pulmonary metastases are the second most common site of metastasis in colorectal cancer after the liver, and microwave ablation (MWA) for its treatment has grown in popularity in patients who are not suitable for pulmonary metastatectomy. However, its long-term efficacy remains unknown.
MATERIALS AND METHODS
A systematic review was conducted in July 2022 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, using PubMed, EMBASE, Scopus, and Cochrane databases. Studies adopting MWA for colorectal cancer pulmonary metastases were included.
RESULTS
A total of 488 lesions were ablated in 230 patients across eight studies. The median duration of ablation was 10 minutes. The mean length of stay in hospital was 2.3 days. Complications included pneumothorax in 128 (52%) patients; pneumonia, which occurred in 4 (1.7%) patients, and pulmonary haemorrhage in 23 (10.0%) patients. Complete remission was achieved in 85 (37.0%) patients, local control was achieved in 103 (44.8%) patients, and residual or progressive disease remained in 85 (37.0%). Survival post ablation at 1 year was 89.2% and at 3 years was 40.3%. Post-ablation disease-free survival was 43.2% at 3 years.
CONCLUSION
MWA is an alternative treatment for pulmonary metastases of colorectal cancer. It has competitive theoretical properties and local recurrence rate compared to radiofrequency ablation.
背景/目的：肺转移是结直肠癌继肝脏之后第二常见的转移部位，对于不适合肺转移切除术的患者，微波消融（MWA）治疗的应用越来越广泛。然而，其长期疗效尚不清楚。
材料和方法
根据系统评价和荟萃分析的首选报告项目，于 2022 年 7 月在 PubMed、EMBASE、Scopus 和 Cochrane 数据库中进行了系统评价。纳入采用 MWA 治疗结直肠癌肺转移的研究。
结果
共有 8 项研究的 230 例患者共消融了 488 个病灶。消融的中位时间为 10 分钟。平均住院时间为 2.3 天。并发症包括 128 例（52%）患者气胸；4 例（1.7%）患者肺炎和 23 例（10.0%）患者肺出血。85 例（37.0%）患者达到完全缓解，103 例（44.8%）患者达到局部控制，85 例（37.0%）患者残留或进展。消融后 1 年的生存率为 89.2%，3 年生存率为 40.3%。消融后 3 年无疾病生存率为 43.2%。
结论
MWA 是结直肠癌肺转移的一种替代治疗方法。与射频消融相比，它具有有竞争力的理论特性和局部复发率。
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