肾上腺动脉栓塞联合微波消融术治疗肾上腺转移瘤

Adrenal artery embolization combined with microwave ablation in the treatment of adrenal metastatic tumors

目的了解经动脉栓塞术(transarterial embolization,TAE)联合微波消融术(microwave ablation,MWA)治疗肾上腺转移瘤的可行性、安全性、有效性。方法回顾性分析2018年1月至2021年12月在山东第一医科大学附属中心医院介入科接受TAE同步联合MWA治疗的21例患者的临床资料。21例患者均经病理确诊为肾上腺转移瘤,均在TAE治疗后于CT引导下行经皮穿刺MWA,术后即刻行CT平扫,术后1、3、6个月及1年行腹部CT/MRI增强检查。随访期间记录患者的不良反应、并发症及生存时间。结果TAE联合MWA的技术成功率为100%。仅有2例患者于术中出现高血压危象,1例患者出现肾上腺功能不全,其余患者仅出现一过性不良反应,对症治疗后均缓解。术后1、3、6个月及1年的完全缓解率分别为95.2%(20/21)、95.2%(20/21)、85.7%(18/21)、80.9%(17/21),部分缓解率分别为4.8%(1/21)、4.8%(1/21)、14.3%(3/21)、19.1%(4/21)。客观缓解率为100%。中位生存时间(OS)为32.5个月,12、18、24个月总生存率分别为100%、85.7%、66.7%。结论TAE联合MWA是可行的,且安全有效,可用于治疗肾上腺转移瘤患者。

Objective To investigate the feasibility,safety and efficacy of transcatheter arterial embolization(TAE)combined with microwave ablation(MWA)in the treatment of adrenal metastatic tumors.Methods The clinical data of 21 patients with pathologically proved adrenal metastatic tumors,who simultaneously received TAE and MWA treatment at the Interventional Department of the Affiliated Central Hospital of Shandong First Medical University of China between January 2018 and December 2021,were retrospectively analyzed.TAE was performed in all the 21 patients,which was followed by CT-guided percutaneous puncture MWA therapy.Plain CT scan was performed immediately after treatment,and enhanced abdominal CT/MRI was performed at 1,3,6,and 12 months after treatment.During the follow-up period,the adverse reactions,complications and survival time were recorded.Results The technical success rate of TAE plus MWA was 100%.Only two patients had hypertension crisis during the procedure,one patient developed adrenal insufficiency,and the remaining patients had transient adverse reactions,which were relieved after symptomatic treatment.At 1,3,6 and 12 months after treatment,the complete remission rates were 95.2%(20/21),95.2%(20/21),85.7%(18/21)and 80.9%(17/21)respectively,and the partial remission rates were 4.8%(1/21),4.8%(1/21),14.3%(3/21)and 19.1%(4/21)respectively.The objective remission rate was 100%.The median survival time(OS)was 32.5 months,and overall survival at 12,18 and24 months after treatment was 100%,85.7%and 66.7%respectively.Conclusion TAE combined with MWA is clinically feasible,safe and effective,which can be used in the treatment of patients with adrenal metastatic tumors.(J Intervent Radiol,2022,31:1060-1064)