Department of Interventional Radiology, Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, China.
Technol Cancer Res Treat. 2023 Jan-Dec;22:15330338231201508. doi: 10.1177/15330338231201508.
This study aimed to evaluate the efficacy of computed tomography (CT) guided percutaneous cryoablation (CA) for the management of lung metastases in patients with metastatic colorectal cancer (mCRC).
Retrospective analysis was performed on 38 mCRC patients with lung metastases, who underwent CT-guided percutaneous CA at our center from May 1, 2020 to November 1, 2021. The technical success rate, 1-year local control (LC) rate, recurrence-free survival (RFS) and treatment-related complications were analyzed.
The CA procedure was successfully performed in all patients, with a technical success rate of 100%. The 1-year LC rate was 94.7% (36/38), while 16 patients experienced new distant lung metastases during the follow-up period. The median RFS was 20 months (95% CI: 13.0-27.0). The median RFS of patients with and without extrapulmonary metastasis was 15 and 23 months, respectively. Complications were reported in 18 (47.4%) patients following the CA procedure. Pneumothorax was discovered in 15 (39.5%) patients, and five of these patients (13.2%) required chest tube intubation. Two patients (5.3%) presented with hemoptysis during the CA procedure. One patient developed subcutaneous emphysema as detected in the post-procedure follow-up imaging. All patients tolerated the peri-procedural pain well under local anesthesia, and the mean visual analog scale (VAS) score was 2.8.
Lung CA is a safe and well-tolerated treatment with a satisfactory local control rate for patients with lung metastases derived from mCRC.
本研究旨在评估 CT 引导下经皮冷冻消融（CA）治疗转移性结直肠癌（mCRC）肺转移患者的疗效。
回顾性分析了 2020 年 5 月 1 日至 2021 年 11 月 1 日在我中心接受 CT 引导下经皮 CA 治疗的 38 例 mCRC 伴肺转移患者。分析了技术成功率、1 年局部控制率（LC）、无复发生存率（RFS）和治疗相关并发症。
所有患者均成功完成 CA 手术，技术成功率为 100%。1 年 LC 率为 94.7%（36/38），随访期间 16 例患者出现新的肺外转移。中位 RFS 为 20 个月（95%CI：13.0-27.0）。无肺外转移患者的中位 RFS 为 15 个月，有肺外转移患者的中位 RFS 为 23 个月。CA 术后有 18 例（47.4%）患者发生并发症。15 例（39.5%）患者出现气胸，其中 5 例（13.2%）需要胸腔引流管置入。2 例（5.3%）患者在 CA 术中出现咯血。1 例患者在术后随访影像学检查中发现皮下气肿。所有患者均在局部麻醉下良好耐受围术期疼痛，平均视觉模拟评分（VAS）为 2.8。
CA 是一种安全且耐受性良好的治疗方法，对于 mCRC 肺转移患者，局部控制率令人满意。
