经皮射频消融治疗局部晚期肺癌78例临床分析

Percutaneous radiofrequency ablation in treatment of advanced local lung cancer： clinical analysis of 78 cases

目的探讨经皮射频消融治疗（RFA）局部晚期肺癌的安全性及临床疗效。方法对78例原发性局部晚期肺癌患者，病灶数78个，在CT引导、局麻或静脉全麻下进行射频消融治疗。消融温度70—90℃，治疗时间5—26min；随访3—6个月，常规行螺旋CT平扫和增强扫描来观察评价治疗结果。结果78例患者共进行103次射频消融，其中19例进行2次，2例行3次射频治疗。32例伴有不同程度的疼痛，18例出现不同程度的咳嗽、咳血。发生气胸23例。RFA后67个肿瘤cT表现为病灶内散在分布小气泡影、肿瘤去血管化或合并体积缩小。结论经皮射频消融治疗局部晚期肺癌，损伤小，安全，能迅速去除瘤负荷，近期疗效确切；远期效果需进一步观察。

Objective To investigate the efficacy and safety of radiofrequency ablation （RFA） in treatment of advanced lung cancer. Methods Seventy-eight patients with advanced local lung cancer were treated with RFA at the temperature from 70 ℃ to 90 ℃ under local or intravenous anesthesia under CT scan for 8 minutes to 26 minutes. 103 times of RFA were done in 78 patients , 19 of them being treated twice and 2 treated tree times. Followed up was conducted for 1 -6 months. The outcomes were evaluated by plain and contrast spiral CT scanning. Results During RFA 32 patients felt pain, and 18 patients experienced cough and hemoptysis. After RFA pneumothorax was seen in 18 of the patients, and contrast spiral CT scanning showed devascularization and/or reduction of tumor size in 67 lesions. Conelusion Removing tumor load rapidly and with excellent short-term outcome, percutaneous RAF is safe to treat advanced local lung cancer.