CT导向下微波消融治疗肝癌肺转移瘤的疗效

Efficacy of CT-guided microwave ablation on lung metastasis from liver cancer

目的：探讨CT导向下微波消融治疗原发性肝癌肺转移瘤的疗效。方法：回顾性分析2009年10月至2014年10月40例肝癌肺转移患者对肺部病灶行微波消融的病例资料，其中男33例，女7例，中位年龄45．5岁。对77个（平均每人1．9个）肺转移灶一共进行了53次微波消融治疗。术后1、3、6个月复查胸部CT评估其临床疗效。结果：消融后1个月胸部CT复查显示，肿瘤的完全消融率达100％。最后一次随访时间为2014年10月20日，24例患者仍然健在，16例患者死于肿瘤进展。中位随访时间为12．1个月（7．3—16．8个月）。中位生存期为28．7个月（95％CI21．5～36．1），1、2、3年生存率分别为73．2％、52．3％、29．1％。无进展生存期为5．8个月（95％CI 3．2—8．5），1年和2年无进展生存率分别为31．5％和613％。术后主要并发症为胸痛（6／40），其次是气胸（3／40）。结论：CT导向下的微波消融治疗肝癌肺转移瘤是一种安全有效且并发症少的微创治疗方法。

Objective To evaluate the safety and efficacy of CT-guided microwave ablation therapy of pulmonary metastases from liver cancer. Methods Forty patients （male 33, female 7, mean age 48） with lung metastasis from liver cancer accepted CT-guided microwave ablation were reviewed from October, 2009 to October, 2014. 40 patients with 77 lesions underwent 53 microwave ablation sessions. Clinical efficacy was evaluated by the chest CT after 1 month, 3 months and 6 months. Results The completed ablation rate was 100% as the chest CT showed one month after ablation. During the median follow-up period of 12.1 months （range 7.3 - 16.8）, 16 patients died of tumour progression and 24 were alive. The 1-, 2- and 3-year overall survival rates were 73.2%, 52.3% and 29.1%, respectively. The median progression free survival was 5.8 months （95% CI 3.2 - 8.5） and the median overall survival time was 28.7 months （95%CI,21.5 - 36.1）. The primary complication was local pain at the puncture site（6/40）. Secondly was pneumothorax（3/40）, two of them （5%） requiring central venous catheter placement occurred in three microwave ablation sessions. Other complications were well tolerated, and easily controlled. Conclusions CT-guided microwave ablation is an effective, micro-invasive method with few complications in treating lung metastasis from liver cancer.