MSCT引导下冷极射频消融治疗难治性恶性肿瘤的应用价值

目的探讨在MSCT引导下经皮穿刺冷极射频消融治疗难治性恶性肿瘤的安全性、疗效及其应用价值。方法76例恶性肿瘤84个瘤灶，瘤体直径3．0～15．0cm，平均8．5cm。根据消融术前MSCT图像制定治疗计划，在MSCT引导下经皮穿刺准确将针型电极插入肿瘤预定位置进行热消融，消融温度58～90℃，治疗时间15～120min。术后2h复查，观察有无急性并发症。术后1个月和每3个月CT复查观察肿瘤有无残留和复发，必要时可多次治疗。通过影像学评估消融的疗效，并统计生存期。结果76例恶性肿瘤84个瘤灶在MSCT引导下消融针均准确插入肿瘤预定位置并顺利完成热消融过程，未见严重并发症。术后1个月复查，84个瘤灶完全坏死15个；不完全坏死和部分坏死45个，总有效率71．43％（60／84）。治疗后生存率随访：6个月90．79％，12个月63．16％，18个月36．84％，24个月14．47％。结论在MSCT引导下经皮穿刺冷极射频消融技术是一种创伤小、易耐受、安全有效的治疗难治性恶性肿瘤的方法。

Clinical value of MSCT guided cool-tip radiofrequency ablation for refractory malignant tumors

Objective To evaluate the safety and efficacy of MSCT guided percutaneous cool-tip radiofrequency ablation treatment for refractory malignant tumors. Methods Eighty four lesions （diameter 3.0-15.0 cm, mean 8.5 cm） in 76 refractory malignant tumor patients underwent percutaneous MSCT guided cool-tip radiofrequency ablation （temperature 58- 90℃, time 15-120 min）. Treatment plan system was adopted based on computed tomography imaging before the procedure. The acute complications were observed immediately post operation and the efficacy was observed every 3 months after the procedure. The survival rate was analyzed. Results The procedure of percutaneous MSCT guided cool-tip radiofre-quency ablation in 84 malignant tumors were all successful. No severe complications occurred. The complete response rate was 17.86% （15/84）, the partial response rate was 53.57% （45/84）, resulting a 71.43% （60/84）overall response rate. The survival rates of 6, 12, 18 and 24 months after the cool-tip radiofrequency ablation operation was 90.79%, 63.16 %, 36.84% and 14.47 %, respectively. Conclusion MSCT guided percutaneous cool-tip radiofrequency ablation is a minimally invasive, safe and effective method for treatment of refractory malignant tumors.