CT引导下经皮微波消融术治疗结直肠癌肺转移的临床疗效分析

CT-guided percutaneous microwave ablation for pulmonary metastases from colorectal cancer

目的：探讨CT引导下微波消融技术在结直肠癌肺转移瘤治疗中的疗效及影响预后的因素。方法收集2010年6月至2015年6月32例结直肠癌肺转移瘤患者，共48个转移灶，均采用CT引导下微波消融治疗。采用Kaplan？Meier法和Cox回归模型进行生存预后分析。结果32例患者的48个病灶完全消融42个，完全消融率为87？5％。术后30天内无1例因微波消融治疗造成死亡，无1例发生针道转移，6例发生气胸。全组患者均获随访，中位无进展生存期为26个月（95％CI：16？790～35？210个月），1、2、3年无进展生存率分别为79？5％、62？8％和43？1％。单因素分析显示，肿瘤大小、无瘤间期及转移瘤数目均与无进展生存期有关（ P＜0？05）；多因素分析显示，肿瘤大小是影响无进展生存期的独立因素（ P＜0？05）。结论CT 引导下微波消融治疗是治疗结直肠癌肺转移瘤安全、有效、微创的方法。

Objective To evaluate safety and efficacy of CT-guided percutaneous microwave ablation in pulmonary metastases from colorectal cancer. Methods From June 2010 to June 2015, 48 unresectable lesions in 32 patients with pulmonary metastases from colorectal cancer were selected for CT-guided microwave ablation. Kaplan-Meier method was used for survival analysis, and multi-variable analysis of prognostic factors was done by Cox regression model. Results Among the 48 lesions of 32 patients, the complete response was achieved in 42 patients （ 87？5%） . No death was observed within 30 days after ablation, and no needle tract implantation metastases happened. Pneumothorax was found in 6 cases. All the patients were followed up. The median progression-free survival time was 26 months （ 95%CI： 16？790？35？210 months ） . The 1, 2 and 3？year progression-free survival rates were 79？5%, 62？8% and 43？1%, respectively. Univariate analysis showed that tumor size, tumor-free interval and number of tumors were significantly related to progression-free survival time （ P〈0？05） . Multivariate analysis showed that tumor size was an independent prognostic factor for progres-sion？free survival （P〈0？05）. Conclusion CT-guided percutaneous microwave ablation is a safe, effective and minimally invasive method to treat pulmonary metastases from colorectal cancer.