The City College of New York, 160 Convent Avenue, New York, 10031, USA.
Memorial Sloan Kettering Cancer Center, Department of Radiology, 1275 York Avenue, New York, NY, 10065, USA.
Surg Oncol. 2024 Aug;55:102102. doi: 10.1016/j.suronc.2024.102102. Epub 2024 Jul 3.
Assess safety and efficacy of thermal ablation for adrenal metastases (AM) secondary to non-small cell lung cancer (NSCLC).
This retrospective study included patients with NSCLC AM treated with thermal ablation between 2/2010-11/2021. Local tumor progression free survival (LTPFS) and overall survival (OS) were calculated using Kaplan-Meier method. Adverse events were graded using Common Terminology Criteria for Adverse Events v5.
Seven patients (mean age ± SD, 63.9 ± 12.5 years; 6 males) with seven AM were treated in eight sessions. Retreatment was performed in one patient with residual disease. Five sessions were with microwave ablation and 3 with radiofrequency ablation. Mean tumor size was 20.1 ± 7.0 mm. Median number of ablation probes used was 1 (range, 1-5), with a median of 3 activations (range, 1-3), and average ablation time of 14.4 ± 15.0 minutes. Response based on RECIST v 1.1 or PERCIST criteria revealed stable disease in 1 tumor, progression of disease in 3 tumors (one was re-ablated), and partial response in 3 tumors. Median LTPFS was not reached (NR) [95 % CI: 1- NR]. Median OS was 47.97 months (95 % CI: 18.63- NR). Intraprocedural hypertension (blood pressure ≥180 mmHg) occurred during 5/8 (62.5 %) sessions and intraoperative tachycardia occurred during 2/8 (25 %) sessions. Complications within one month of ablation occurred in 3/8 (37.5 %) sessions: grade 2 pneumothorax, grade 1 hematuria, and grade 2 adrenal insufficiency.
In this small series, thermal ablation for NSCLC AM resulted in prolonged local control and OS with no major complications.
评估热消融治疗非小细胞肺癌（NSCLC）继发肾上腺转移瘤（AM）的安全性和疗效。
本回顾性研究纳入了 2010 年 2 月至 2021 年 11 月期间接受热消融治疗的 NSCLC-AM 患者。采用 Kaplan-Meier 法计算局部肿瘤无进展生存期（LTPFS）和总生存期（OS）。采用不良事件通用术语标准 v5 对不良反应进行分级。
7 例（平均年龄±标准差，63.9±12.5 岁；男性 6 例）患者的 7 个 AM 共进行了 8 次治疗。1 例患者因残留疾病进行了再次治疗。5 次为微波消融，3 次为射频消融。平均肿瘤大小为 20.1±7.0mm。使用的消融探针中位数为 1（范围，1-5）个，消融激活中位数为 3（范围，1-3）次，平均消融时间为 14.4±15.0 分钟。根据 RECIST v1.1 或 PERCIST 标准，1 个肿瘤显示为疾病稳定，3 个肿瘤显示为疾病进展（1 个进行了再消融），3 个肿瘤显示为部分缓解。中位 LTPFS 未达到（NR）[95%置信区间：1-NR]。中位 OS 为 47.97 个月（95%置信区间：18.63-NR）。8 次治疗中有 5 次（62.5%）出现术中高血压（血压≥180mmHg），有 2 次（25%）出现术中心动过速。消融后 1 个月内发生 3 例（37.5%）并发症：2 级气胸、1 级血尿和 2 级肾上腺功能不全。
在这项小系列研究中，热消融治疗 NSCLC-AM 可延长局部控制和 OS，且无严重并发症。
