CT引导微波治疗难治性结直肠癌肝转移的临床研究

Effects of CT guided microwave ablation on refractory liver metastases of colorectal cancer

目的:探讨CT引导经皮穿刺微波消融治疗难治性结直肠癌肝转移的临床疗效。方法:26例化疗无效的结直肠癌肝转移患者,在CT引导下行经皮穿刺肝转移瘤微波消融治疗,微波频率2450MHz,输出功率20～80W,持续时间5～30min。治疗后3个月复查肝脏增强CT或MRI,评价肝转移瘤的疗效。结果:共治疗51次,治疗肿瘤数目46个。21例患者肝脏肿瘤的最大长径总和减少,其中4例患者肿瘤消失,13例患者肿瘤的最大长径总和减少30%以上,有效率(CR+PR)为65.4%,疾病控制率(CR+PR+SD)为80.8%,CT或MRI表现为病灶密度减低或出现气化灶。微波消融后1、2、3年的累计生存率分别为73.1%(19例)、53.8%(14例)、26.9%(7例),中位生存期为21个月。结论:CT引导经皮穿刺微波消融治疗难治性结直肠癌肝转移微创、有效。

Objective To investigate the effects of CT guided percutaneous microwave ablation on refractory liver metastases of colorectal cancer. Methods Twenty-six patients with liver metastases of colorectal cancer, on whom the chemotherapy was ineffective, underwent CT guided percutaneous microwave ablation treatment. The microwave energy was set at 2 450 MHz and at 20-80 watt for 5-30 min. CT or MRI scan was performed 3 months after the treatment to evaluate the efficacy. Results Forty-six metastatic cancer focuses were treated for about 51 times. According to the resuhs of the CT or MRI scan, there were 4 cases with complete remission （CR）, 13 with partial remission （PR）, and 4 with stable disease （SD）. The summation of the max diameter of all the cancer focuses was decreased. The overall disease control rate and effective rate were 80.8% and 65.4%. Lower density or gasification in the coagulated area was observed by CT or MRI scanning. The 1-, 2-, 3- years survival rate were 73.1% （19/26）, 53.8% （14/26）, and 26.9% （7/26）, respectively; and the median survival time was 21 months. Conclusion CT guided percutaneous microwave ablation may be a minimally invasive and effective method in the treatment for refractory liver metastases of colorectal cancers.