CT引导下经皮微波消融治疗乳腺癌肝转移瘤18例

CT Guided Percutaneous Microwave Ablation of 18 Cases of Breast Cancer Liver Metastases

目的探讨经皮微波消融治疗乳腺癌肝转移的有效性和其对患者生存期的影响。方法乳腺癌肝转移患者18例，平均年龄54岁，采用CT引导下经皮微波消融治疗。微波消融治疗后的平均随访时间为24．1月（8-52月）。肝转移瘤的平均个数为1．7（1-4个），最大直径为4．2cm。共计28个肝转移瘤总共行28次微波消融治疗。术后评估肿瘤完全坏死率、安全性、有无局部肿瘤进展及患者的生存期。结果所有28个肿瘤均达到了完全坏死。在随后的随访中18例患者中有5例出现了新的转移灶。该5例患者中有3例出现了新的肝转移，均再次接受了微波消融治疗。3例患者出现轻微的并发症，如疼痛和气胸，经对症处理后缓解。所有18例患者整体中位生存期为42．6月。有4例患者死于器官衰竭。结论CT引导的经皮微波消融治疗乳腺癌肝转移是一种有效和非常有前景的方法。

Objective This retrospective study aimed to evaluate the effectiveness of percutaneous microwave ablation in the treatment of liver metastases from breast carcinoma, and its effect on the patients＇ survival. Methods 18 cases of liver metastases from nasopharyngeal carcinoma patients （average age 46 years old） received CT guided percutaneous microwave ablation treatment. The average follow up post-ablation was 24.1 months （ranging from 8 - 52 months）. The average number of liver metastases per patient was 1.7 （ranging from 1-4 lesions）, with the maximum diameter at 4.2cm. A total of 28 ablations were performed to 28liver metastases in 18MWA sessions. The ablation sites were then evaluated for percentage of complete necrosis, safety, local tumor progression and patients＇ survival. Results All 27 ablations induced complete necrosis. In follow up, 5 out of 18patients showed new metastases lesion. 3 out of 5 metastases patients had liver metastases, and 43 patients received microwave ablation treatment again. The 3 patients had three metastases lesion in total, and all three lesions achieved complete ablation after microwave ablation treatment. Two minor complications occurred in all cases. The average survival of the 18 patients in this study was 42.6 months. 4 out of 8 patients died of organ failure at the end. Conclusion CT-guided MWA is safe and offers an effective treatment alternative for local tumor control in selected patients with liver metastases from breast carcinoma.