Clinic for Radiology and Nuclear Medicine, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
Department of Medical Imaging and Intervention, College of Medicine, Chang Gung Memorial Hospital-Linkou, Chang Gung University, Taoyuan, Taiwan.
Sci Rep. 2024 Oct 26;14(1):25491. doi: 10.1038/s41598-024-76323-y.
To verify the treatment effect of the combination of transpulmonary chemoembolization (TPCE) and microwave ablation (MWA), targeting the treatment of recurrent or advanced non-small cell lung cancer (NSCLC). A total of 53 patients were studied and grouped according to the diameter of the largest pulmonary nodule, defined as index tumor size (ITS). Patients with an ITS > 3 cm (n = 20) were treated with TPCE and MWA. Patients with an ITS ≤ 3 cm were treated either with a combination therapy (n = 24) or MWA alone (n = 9). The treatment response, including complications and survival outcome, was then analyzed. After TPCE, there was an average ITS reduction of 0.91 cm, and 25% of patients in ITS > 3 cm were downgraded to ITS ≤ 3 cm. After TPCE, there were 12 patients (27%) with PR status and 32 (73%) with SD status. No PD patient in our case series was noted before MWA.The complication rate of MWA was significantly higher in ITS ≤ 3 cm than in ITS > 3 cm (p = 0.013). The median survival time (MST) was 26.7 months, and the time to progression was 13.2 months. The patients in the ITS ≤ 3 cm had longer MST than the others (31.6 vs. 15.8 months, p = 0.003). The significant prognostic factor was ITS > 3 cm (HR: 1.18, p = 0.02). A combination of TPCE and MWA might be feasible to control non-operable, recurrent, or advanced NSCLC.
为了验证经肺化疗栓塞术(TPCE)联合微波消融(MWA)治疗复发性或晚期非小细胞肺癌(NSCLC)的疗效,对 53 例患者进行了研究,并根据最大肺结节直径进行分组,定义为指标肿瘤大小(ITS)。ITS>3cm(n=20)的患者接受 TPCE 和 MWA 治疗。ITS≤3cm 的患者接受联合治疗(n=24)或单独 MWA 治疗(n=9)。然后分析治疗反应,包括并发症和生存结果。TPCE 后,ITS 平均缩小 0.91cm,25%的 ITS>3cm 的患者降期为 ITS≤3cm。TPCE 后,12 例(27%)患者 PR 状态,32 例(73%)患者 SD 状态。MWA 前未发现病例系列中 PD 患者。ITS≤3cm 的 MWA 并发症发生率明显高于 ITS>3cm(p=0.013)。MWA 的中位生存时间(MST)为 26.7 个月,进展时间为 13.2 个月。ITS≤3cm 的患者 MST 长于其他患者(31.6 vs. 15.8 个月,p=0.003)。ITS>3cm 是显著的预后因素(HR:1.18,p=0.02)。TPCE 联合 MWA 可能是控制不可手术、复发性或晚期 NSCLC 的可行方法。