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非小细胞肺癌肾上腺转移的经皮消融:冷冻消融与微波消融的比较

Percutaneous ablation for adrenal metastasis from non-small-cell lung cancer: comparison between cryoablation and microwave ablation.

作者信息

Zhang Wei, Liu Wei, Wu Zheng-Long, Zhao Zhi-Yong, Ma Wei-Ming

机构信息

Department of Liver Disease, Daxing Hospital, Xi'an, China.

Department of Oncology, Xuzhou Central Hospital, Xuzhou, China.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2024 Mar;19(1):52-59. doi: 10.5114/wiitm.2024.134804. Epub 2024 Jan 30.

Abstract

INTRODUCTION

While cryoablation (CA) and microwave ablation (MWA) have both been implemented as approaches to the treatment of adrenal metastasis (AM), the outcomes associated with these two therapeutic strategies remain unclear.

AIM

To compare the safety and efficacy of CA and MWA as treatments for AM in patients with non-small-cell lung cancer (NSCLC).

MATERIAL AND METHODS

Consecutive patients with AM secondary to NSCLC from January 2015 to December 2020 underwent CA or MWA. Treatment-related outcomes and complications were retrospectively compared between these groups.

RESULTS

In total, 68 NSCLC patients with isolated AM were enrolled in this study, of whom 35 and 33 underwent treatment with CA and MWA, respectively. Primary complete ablation rates in the CA and MWA groups were 91.4% (32/35) and 93.9% (31/33) respectively (p = 1.000), while a 100% secondary complete ablation rate was observed for both groups. Hypertensive crisis incidence affected 11.4% (4/35) and 9.1% (3/33) of patients in the CA and MWA groups (p = 1.000), respectively, while 8 (22.9%) and 8 (24.2%) patients in these corresponding groups experienced local progression after ablation that was detected during the follow-up period (p = 0.893). Patients in the CA and MWA groups exhibited a median progression-free survival of 18 and 22 months, respectively (p = 0.411), while the corresponding median overall survival of patients in these groups was 25 and 29 months (p = 0.786).

CONCLUSIONS

CT-guided CA and MWA appear to exhibit similar safety and efficacy profiles when employed to treat isolated AM in NSCLC patients.

摘要

引言

虽然冷冻消融(CA)和微波消融(MWA)均已作为肾上腺转移瘤(AM)的治疗方法,但这两种治疗策略的相关结果仍不明确。

目的

比较CA和MWA治疗非小细胞肺癌(NSCLC)患者AM的安全性和疗效。

材料与方法

对2015年1月至2020年12月期间连续的继发于NSCLC的AM患者进行CA或MWA治疗。对这些组之间的治疗相关结果和并发症进行回顾性比较。

结果

本研究共纳入68例孤立性AM的NSCLC患者,其中35例和33例分别接受了CA和MWA治疗。CA组和MWA组的初次完全消融率分别为91.4%(32/35)和93.9%(31/33)(p = 1.000),而两组的二次完全消融率均为100%。CA组和MWA组分别有11.4%(4/35)和9.1%(3/33)的患者发生高血压危象(p = 1.000),而在随访期间,这些相应组中分别有8例(22.9%)和8例(24.2%)患者在消融后出现局部进展(p = 0.893)。CA组和MWA组患者的无进展生存期中位数分别为18个月和22个月(p = 0.411),而这些组患者相应的总生存期中位数分别为25个月和29个月(p = 0.786)。

结论

在治疗NSCLC患者的孤立性AM时,CT引导下的CA和MWA似乎具有相似的安全性和疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf31/11223533/5923f9889869/WIITM-19-52327-g001.jpg

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