摘要

BACKGROUND:Image-guided percutaneous radiofrequency ablation (RFA) has been proposed as an efficacious local therapy for lung metastases in nonsurgical candidates. Reports of long-term outcome from this treatment have been limited.
METHODS:A prospective open-labeled trial of RFA was initiated in November 2000 for treatment of lung metastases in nonsurgical candidates. RFA was carried out under fluoroscopic computed tomography. Treatment complications and survival parameters were analyzed.
RESULTS:Of 148 patients treated, 66 patients (46%) had a complete response, 38 patents (26%) had a partial response, 57 patients (39%) had stable disease and 23 patients (16%) had progressive disease. The median progression-free survival was 11 months [95% confidence interval (CI) 9-14]. The median overall survival and 3- and 5-year survivals were 51 months (95% CI 19-83) and 60% and 45%, respectively. Disease-free interval (P = 0.013) and response to treatment (P = 0.002) were independent predictors for overall survival. Complications occurred in up to 45% of patients, of which 45 patients (30%) required chest tube placement.
CONCLUSION:This analysis confirms that RFA of lung metastases may achieve long-term survival in nonsurgical candidates with an acceptable complication rate hence supporting its incorporation into the oncosurgical management of lung metastases for the purposes of cure, stabilization and disease prolongation.

译文

背景: 图像引导下经皮射频消融 (RFA) 已被提出作为非手术候选肺转移的有效局部治疗。这种治疗的长期结果报告有限。
方法: 2000年11月开始了一项前瞻性开放标记 RFA 试验，用于治疗非手术候选肺转移。RFA 是在透视计算机断层扫描下进行的。分析治疗并发症和生存参数。
结果: 在 148 名接受治疗的患者中，66 名患者 (46%) 有完全反应，38 名患者 (26%) 有部分反应，57 名患者 (39%) 病情稳定，23 名患者 (16%) 病情进展。中位无进展生存期为 11 个月 [95% 置信区间 (CI) 9-14]。中位总生存期和 3 年和 5 年生存期分别为 51 个月 (95% CI 19-83) 和 60% 和 45%。无病间期 (P = 0.013) 和治疗反应 (P = 0.002) 是总生存期的独立预测因素。高达 45% 的患者出现并发症，其中 45 名患者 (30%) 需要放置胸管。
结论: 这一分析证实了肺转移的 RFA 可能在非手术的候选患者中获得长期生存，并具有可接受的并发症发生率，因此支持将其纳入肺转移的外科治疗中，以达到治愈的目的。稳定和疾病延长。