射频消融治疗全肺切除术后转移癌:5例临床分析

目的:回顾性评价CT引导下经皮射频消融(radiofrequency ablation, RFA)治疗全肺切除术后转移癌的可行性、有效性和安全性。方法:2010年01月至2022年05月，5例单肺转移癌患者(5例男性，平均年龄59.6岁),共接受了8次RFA治疗。4例患者为原发肺癌术后转移癌，1例患者为肾盂输尿管肿瘤肺转移。其中2例患者因肿瘤局部复发而分别接受了2次和3次RFA。8个RFA治疗的肿瘤大小2.0～5.0 cm(平均3.0 cm)。根据RFA后立即进行的CT检查及临床随访结果评估RFA治疗全肺切除术后转移癌的可行性、有效性及安全性。结果:术后并发症包括气胸(37.5%)、胸痛(37.5%)以及以低热为主要表现的消融后综合征(25.0%)。没有一例患者在手术期间或RFA后30天内死亡。死亡病例存活期分别为3个月、25个月、33个月。1例首次RFA后38个月随诊仍然生存，1例术后3个月随诊仍然生存。结论:RFA可以在全肺切除术后提供局部肿瘤控制，并且可以重复射频。RFA治疗全肺切除术后转移癌安全、可行、有效。

Radiofrequency ablation for metastatic tumor after pneumonectomy:Clinical evaluation of 5 cases

Objective:To retrospectively evaluate the feasibility,effectiveness and safety of CT guided percutaneous radiofrequency ablation (RFA) in the treatment of metastatic tumor after pneumonectomy.Methods:From January 2010 to May 2022,5 patients with single lung metastasis tumors (5 males,mean age 59.6 years old) underwent 8 times of RFA.4 patients had postoperative metastasis of primary lung cancer and 1 patient had lung metastasis of renal pelvis and ureter tumor.One patient underwent two RFAs due to local recurrence of the tumor.Another patient underwent three RFAs due to local recurrence of the tumor.The mean tumor size was 3.0 cm (range from 2.0 to 5.0 cm).According to the CT examination immediately after RFA and clinical follow-up results,the feasibility,effectiveness and safety of RFA in the treatment of metastatic tumors after pneumonectomy were evaluated.Results:Complications after RFA included pneumothorax (37.5%),chest pain (37.5%) and post-ablation syndrome (25.0%) with low fever as the main manifestation.None of the patients died during the procedure or in the 30 days after RFA.The survival periods of dead cases were 3 months,25 months and 33 months,respectively.One case survived for 38 months after the first RFA and the other case survived for 3 months.Conclusion:RFA can offer local tumor control after pneumonectomy and can be conducted repeatly after pneumonectomy.RFA is safe,feasible and effective for the treatment of metastatic tumors after pneumonectomy.