CT引导经皮穿刺微波消融治疗周围型肺癌27例临床分析

Clinical evaluation of CT-guided percutaneous microwave ablation for 27 patients with inoperable non-small cell lung cancer

目的观察不能耐受手术切除的周围型非小细胞肺癌(NSCLC)在CT引导下经皮微波消融(MWA)治疗的临床疗效。方法 2010年2月至2011年7月采用MWA对27例周围型NSCLC患者的27个肿瘤进行了治疗,肿瘤的中位直径为2.9 cm。按照改良的RECIST标准进行局部疗效评价,对中位生存时间和1年、2年和3年生存率以及术后并发症进行了分析。对所有的患者进行了随访,中位随访时间23个月。结果 27例患者经历了27个病灶的MWA,在术后30 d内未发生死亡。局部进展率为29.7%,中位生存时间22个月,1年、2年和3年生存率分别为70.4%、22.2%和7.4%。MWA术后气胸的发生率为44.4%、胸腔积液为29.6%、咯血为25.9%、肺内感染为14.8%。结论 MWA对于不能耐受外科手术切除的周围型NSCLC疗效确切、安全可靠。

Objective To retrospectively evaluate the clinical efficacy of CT-guided percutaneous micro-wave ablation （MWA） for treating inoperable periphera non-small cell lung cancer （NSCLC）. Methods From Febru-ary 2010 to July 2011, 27 patients with inoperable NSCLC （27 tumors） underwent CT-guided MWA. The median di-ameter of tumor was 2.9 cm. Treatment outcomes were evaluated using modified response evaluation criteria in solid tumors criteria based on follow-up contrast-enhanced CT studies. Median overall survival and 1-, 2-, 3-year overall survival rates, and postoperative complications were also summarized. All the patients were followed up for a medium of 23 months. Results Treatment was completed in all cases with no mortality in 30 days. During the follow-up, lo-cal progression was 29.7%, and median overall survival was 22 months. The 1-, 2-, and 3-overall survival rates after MWA were 70.4%, 22.2% and 7.4%, respectively. The complications after MWA included pneumothorax （44.4%）, pleural effusion （29.6%）, hemoptysis （25.9%）, pulmonary infection （14.8%）. Conclusion CT-guided MWA is a well-tolerated, safe and effective method for the treatment of inoperable periphera NSCLC.