微波消融治疗肺恶性肿瘤安全性及疗效的单中心临床分析

The safety and efficacy of microwave ablation in the treatment of lung cancer: A clinical analysis of single center

目的评估微波消融(MWA)治疗肺恶性肿瘤的安全性及疗效。方法回顾性分析单中心2019年1月至2020年8月采用MWA治疗的31例肺恶性肿瘤患者临床资料,其中男17例、女14例,年龄(63.4±10.4)岁。详细记录病灶特征、技术成功率、技术有效率、局部进展率、不良反应及并发症发生情况。结果共39个靶病灶,平均直径(20.2±10.6)mm,共完成36次MWA。初始技术成功率84.6%(33/39),技术有效率92.3%(36/39)。术后中位住院时间2.0(2.0,3.0)d。12.9%(4/31)的患者出现局部进展,局部控制率为87.1%。不良反应主要为疼痛(12/36,33.3%)、咳嗽(6/36,16.7%)、消融后综合征(6/36,16.7%)和胸腔积液(3/36,8.3%)。主要并发症为气胸(11/36,30.6%)、出血(8/36,22.2%)、空洞(2/36,5.6%)和肺部感染(1/36,2.8%)。中位随访时间13.0(8.0,18.0)个月,随访期间无患者死亡。结论 MWA治疗肺恶性肿瘤安全有效,并发症可控。后续需要大样本、中长期随访研究探讨联合治疗的意义。

Objective To evaluate the safety and efficacy of microwave ablation(MWA) in the treatment of lung tumors. Methods The clinical data of 31 patients with lung neoplasms treated with MWA from January 2019 to August 2020 in a single center were retrospectively analyzed. There were 17 males and 14 females at an age of 63.4±10.4 years. The characteristics of the lesions, technical success rate, technical efficiency, local progression rate, adverse reactions and complications were recorded in detail. Results There were 39 target lesions with an average diameter of 20.2±10.6 mm. A total of 36 MWA procedures were completed. The initial technical success rate was 84.6%(33/39), and the technical efficiency was 92.3%(36/39). The median postprocedure hospital stay was 2.0(2.0, 3.0) d. A total of 12.9%(4/31) of the patients had local progression, and the local control rate was 87.1%. The main adverse reactions were pain(12/36, 33.3%),cough(6/36, 16.7%), post-ablation syndrome(6/36, 16.7%) and pleural effusion(3/36, 8.3%). The main complications were pneumothorax(11/36, 30.6%), hemorrhage(8/36, 22.2%), cavitation(2/36, 5.6%) and pulmonary infection(1/36,2.8%). The median follow-up time was 13.0(8.0, 18.0) months. No patient died during the follow-up. Conclusion MWA is safe and effective in the treatment of lung tumors with controllable complications. Successive researches with large sample, and medium and long-term follow-ups are needed to explore the significance of combined therapies.