CT引导下射频消融治疗肺部恶性肿瘤的疗效评价

目的探讨CT引导下肺恶性肿瘤射频消融后的影像学表现、临床疗效及安全性。方法对32例患者共39个肺部肿瘤病灶行CT引导下射频消融,直至即时CT影像上出现磨玻璃影覆盖病灶周围;术后1个月进行复查,其后每3个月随访,并评估影像学上消融灶变化。结果射频消融过程均顺利,无严重的治疗相关性并发症;病灶完全消融率89.19%(33/37),不完全消融率10.81%(4/37);术后1个月消融灶多表现为空洞样或结节样,长期随访中,完全消融的病灶多呈缩小趋势,而不完全消融的4个病灶均出现复发。中位总生存期为21.0月,中位无进展生存时间为17.3个月,中位疾病进展时间为18.0个月。结论 CT引导下射频消融治疗肺部恶性肿瘤安全性好,且病灶控制率高。

Effect evaluation on radiofrequency ablation under CT guidance for pulmonary malignant tumors

Objective To investigate the imaging feature, efficacy and safety after radiofrequency ablation (RFA) under CT guidance for pulmonary malignant tumors. Methods Totally 32 patients with 39 lesions underwent RFA under CT guidance until the ground-glass opacities around the lesions. Post-RFA follow-up was divided into: 1 month after RFA, and then every 3 months. The imaging changes was assessed. Results The procedure was successful in all patients. No serious procedure-associated complications occurred. Complete ablation response was found in 33 lesions (33/37, 89.19%), and partial ablation response was in 4 lesions (4/37, 10.81%). Most of the ablation zones were cavities or nodules a month later. In the long-term follow-up, the imaging changs of completely ablation lesions showed a trend of shrinking, and recurrences were detected in all partial ablation lesions. Overall survival was 21.0 months. The median progression-free-survival was 17.3 months. The median time-to-progression was 18.0 months. Conclusion Radiofrequency ablation treatment under CT guidance is safe and effective for patients with pulmonary malignant tumors.