CT导向射频消融治疗肺部恶性肿瘤

目的 探讨CT导向下经皮肺穿刺射频消融治疗肺部肿瘤的有效性、安全性及并发症。方法 对不能手术的74例原发肺癌（其中鳞癌23例,腺癌48例,鳞腺癌2例,大细胞癌1例）和14例转移性肺癌共96个病灶（其中最大直径≤3 cm31个,3～5 cm 56个,〉5 cm 9个）,在CT导向下行射频消融治疗,术后6个月随访评价疗效。结果 88例患者共行134次射频消融治疗,除1例术中癫痫发作中断手术而行二期射频消融治疗外,其余均顺利完成。术后6个月行CT复查,显示96个病灶体积中88个均进行性缩小,肿瘤内大片不规则低密度区,总有效率为91.7%。1年随访有效率为88.0%,1年无疾病进展生存率为95.5%。气胸发生率为7.9%。结论 CT导向下经皮肺穿刺射频消融治疗肺部肿瘤安全、有效,并发症较少,对不同肿瘤采取科学的射频消融治疗方案可取得较好的疗效。

To evaluate the efficiency of CT-guided radiofrequency ablation to treat pulmonary malignancies

Objective To evaluate the safety and therapeutic value of CT-guided radiofrequency ablation（RFA）in the treatment of pulmonary malignancies. Methods A total of 88 patients with lung malignancies,who altogether had 96 lesions,were treated using CT-guided RFA. The cohort included 14 cases of metastatic lung carcinoma and 74 cases of primary non-small cell lung cancer （NSCLC）,which comprised various pathological types（23 cases of squamous cell carcinoma,48 adenocarcinoma,2 mixed carcinoma and 1 large cell carcinoma）and tumor sizes （≤3 cm,31 cases;3-5 cm,56 cases;〉5 cm,9 cases）. Results Lesions in most patients became larger and showed fuzzy edges after RFA;some lesions showed bubble-like changes. Follow-up CT at 6 months showed that all 96 lesions had shrunk,with an overall efficacy of 91.6%. The 1-year local control rate was 88.0%,and the 1-year survival rate was 95.5%. Conclusion CT-guided percutaneous RFA is a safe,effective and minimally invasive therapy for treating pulmonary malignancies.