Adwan Hamzah, Hammann Lars, Bielfeldt John, Becker Sven, Vogl Thomas J
Clinic for Radiology and Nuclear Medicine, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany.
Department of Gynecology and Obstetrics, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany.
Radiol Med. 2025 Mar 18. doi: 10.1007/s11547-025-01966-4.
To compare the outcomes of patients with pulmonary metastases from breast cancer, who were treated with transvenous pulmonary chemoembolization (TPCE) and consecutive microwave ablation (MWA) with patients treated by TPCE alone.
This retrospective single-center study included patients with unresectable and/or non-responsive to systemic chemotherapy pulmonary metastases originating from breast cancer, treated by TPCE followed by MWA, in case of adequate response to TPCE, or by TPCE alone. The groups of patients were balanced using propensity score matching (PSM).
A total of 97 patients met the inclusion criteria for this study. After PSM, 23 patients were included in the combination therapy group (Group 1) and 42 patients were included in the monotherapy group (Group 2). The median overall survival (OS) time was 33.6 months for Group 1 with a 2-year OS rate of 62%, and 20.2 months for Group 2 with a 2-year OS rate of 43%. There was no significant difference between the two groups regarding OS (p value: 0.429). The rate of progressive/recurrent disease was 17.4% (4/23) in Group 1 and 23.8% (10/42) in Group 2 (p value: 0.754). The number of metastases was the only significant factor for OS in all patients after PSM (p value: 0.032, HR: 1.016, 95% CI 1.001-1.031).
TPCE is an effective potential treatment for lung metastases of breast cancer, which can be performed alone or combined with MWA. Patients who responded to TPCE and received subsequent MWA demonstrated non-significant better OS and local tumor control.
比较经静脉肺化疗栓塞术（TPCE）联合序贯微波消融术（MWA）治疗的乳腺癌肺转移患者与单纯接受TPCE治疗的患者的预后。
这项回顾性单中心研究纳入了源于乳腺癌的不可切除和/或对全身化疗无反应的肺转移患者，若对TPCE反应良好，则先接受TPCE治疗，随后进行MWA；若对TPCE反应不佳，则仅接受TPCE治疗。采用倾向评分匹配法（PSM）使患者组达到均衡。
共有97例患者符合本研究的纳入标准。PSM后，联合治疗组（第1组）纳入23例患者，单药治疗组（第2组）纳入42例患者。第1组的中位总生存期（OS）为33.6个月，2年OS率为62%；第2组的中位总生存期为20.2个月，2年OS率为43%。两组的总生存期无显著差异（p值：0.429）。第1组的疾病进展/复发率为17.4%（4/23），第2组为23.8%（10/42）（p值：0.754）。PSM后，转移灶数量是所有患者总生存期的唯一显著影响因素（p值：0.032，风险比：1.016，95%置信区间1.001 - 1.031）。
TPCE是治疗乳腺癌肺转移的一种有效的潜在治疗方法，可单独进行或与MWA联合使用。对TPCE有反应并随后接受MWA的患者显示出总生存期和局部肿瘤控制方面虽无显著改善但稍好的情况。
