CT引导微波治疗难治性结直肠癌肝转移的临床研究

目的:探讨CT引导经皮穿刺微波消融治疗难治性结直肠癌肝转移的临床疗效.方法:26例化疗无效的结直肠癌肝转移患者,在CT引导下行经皮穿刺肝转移瘤微波消融治疗,微波频率2 450 MHz,输出功率20 ～ 80 W,持续时间5～ 30 min.治疗后3个月复查肝脏增强CT或MRI,评价肝转移瘤的疗效.结果:共治疗51次,治疗肿瘤数目46个.21例患者肝脏肿瘤的最大长径总和减少,其中4例患者肿瘤消失,13例患者肿瘤的最大长径总和减少30％以上,有效率(CR+ PR)为65.4％,疾病控制率(CR+ PR+ SD)为80.8％,CT或MRI表现为病灶密度减低或出现气化灶.微波消融后1、2、3年的累计生存率分别为73.1％(19例)、53.8％(14例)、26.9％(7例),中位生存期为21个月.结论:CT引导经皮穿刺微波消融治疗难治性结直肠癌肝转移微创、有效.

Effects of CT guided microwave ablation on refractory liver metastases of colorectal cancer

Objective To investigate the effects of CT guided percutaneous microwave ablation on refractory liver metastases of colorectal cancer. Methods Twenty-six patients with liver metastases of colorectal cancer, on whom the chemotherapy was ineffective, underwent CT guided percutaneous microwave ablation treatment. The microwave energy was set at 2 450 MHz and at 20-80 watt for 5-30 min. CT or MRI scan was performed 3 months after the treatment to evaluate the efficacy. Results Forty-six metastatic cancer focuses were treated for about 51 times. According to the results of the CT or MRI scan, there were 4 cases with complete remission (CR), 13 with partial remission (PR), and 4 with stable disease (SD). The summation of the max diameter of all the cancer focuses was decreased. The overall disease control rate and effective rate were 80.8% and 65.4%. Lower density or gasification in the coagulated area was observed by CT or MRI scanning. The 1-, 2-, 3-years survival rate were 73.1% (19/26), 53.8% (14/26), and 26.9% (7/26), respectively; and the median survival time was 21 months. Conclusion CT guided percutaneous microwave ablation may be a minimally invasive and effective method in the treatment for refractory liver metastases of colorectal cancers.