CT导引微波消融治疗高龄老人早期周围型非小细胞肺癌32例  

CT-guided microwave ablation for the treatment of early stage peripheral NSCLC in 32 elderly patients

作　　者：韩晓颖[1] 杨霞[1] 叶欣[1] 黄广慧[1] 危志刚[1] 李文红[1] 倪阳[1] 孟敏 王娇[1] HAN Xiaoying;YANG Xia;YE Xin;HUANG Guanghui;WEI Zhigang;LI Wenhong;NI Yang;MENG Min;WANG Jiao(Department of Oncology,Eastern Branch of Affiliated Provincial Hospital,Shandong University,Jinan,Shandong Province 250021,China)

机构地区：[1]山东大学附属省立医院东院肿瘤中心,济南250021

出　　处：《介入放射学杂志》2018年第11期1051-1055,共5页Journal of Interventional Radiology

摘　　要：目的评估CT导引下经皮微波消融(MWA)治疗高龄老人早期周围型非小细胞肺癌(NSCLC)的疗效。方法回顾性分析2008年1月至2017年9月采用初始CT导引MWA治疗的32例病理学证实为周围型NSCLC高龄患者临床资料,记录临床参数和术后并发症。随访7～70个月,采用Kaplan-Meier法计算中位总生存期(mOS)、总生存率、中位肿瘤特异性生存期(mCSS)、肿瘤特异性生存率、中位无疾病进展期(mPFS)及局部控制率。结果 32例成功完成33次MWA,均为完全消融。术后30 d内死亡率为零,主要并发症发生率为21.2%(7/33)。截至2018年3月31日中位随访时间为18.5个月, 9例(28.1%)死亡,其中3例为非肿瘤原因。mOS为38个月(95%CI 12.7～63.3),1、3、5年总生存率分别为100%、58.7%、31.9%;mCSS为67个月(95%CI 33.7～100.3),1、3、5年肿瘤特异性生存率分别为100%、65.6%、52.5%。8例(34.8%)出现局部进展,局部mPFS为(47.2±5.8)个月,1、2年局部控制率分别为87.3%、67.5%。结论 CT导引MWA治疗高龄老人早期周围型NSCLC安全有效,可带来显著生存获益。Objective To assess the clinical outcome of CT-guided percutaneous microwave ablation（MWA） in treating early stage peripheral non-small cell lung cancer（NSCLC） in elderly patients over 80 years. Methods The clinical data of 32 elderly patients with pathologically-proved stage I peripheral NSCLC, who received CT-guided percutaneous MWA at authors＇ hospital during the period from January2008 to September 2017, were retrospectively analyzed. The clinical parameters and postoperative complications were documented. The patients were followed up for 7-70 months. Using Kaplan-Meier analysis, the median overall survival（mOS）, overall survival rate, median cancer-specific survival（mCSS）,cancer-specific survival rate, median progression-free survival（mPFS）, and local control rate were evaluated.Results A total of 33 procedures of MWA were successfully performed in 32 elderly patients, and complete ablation was achieved in all patients. The death rate was zero within 30 days after MWA, the incidence of major complications was 21.2%（7/33）. Up to March 31, 2018, the median follow-up time was 18.5 months.Nine patients（28.1% died, and in 3 of them the death was due to non-neoplastic causes. The mOS was 38 months（95%CI：12.7-63.3 months）, the one-, 3-and 5-year overall survival rates were 100%, 58.7% and31.9% respectively. The mCSS was 67 months（95%CI：33.7-100.3）, the one-, 3-and 5-year cancer-specific survival rates were 100%, 65.6% and 52.5% respectively. Local progression was observed in 8 patients（34.8%）, the local mPFS was（47.2±5.8） months, the one-year and 2-year local control rates were 87.3%and 67.5% respectively. The mortality rate within 30 days after MWA was 0%, and the incidence of major complications was 21.2%. Conclusion In treating elderly patients with early stage peripheral NSCLC, CTguided percutaneous MWA is safe and effective with significant survival benefits.

关 键 词：老年人 非小细胞肺癌 微波消融 

分 类 号：R734.2[医药卫生—肿瘤]