Background and objective: In recent years, radiofrequency ablation (RFA) has been increasingly utilized as a non-surgical treatment option for patients with primary and metastatic lung tumors. The aim of this study is to evaluate the safety and therapeutic effects of RFA among patients with pulmonary neoplasms.
Methods: Patients with lung tumors treated with RFA from October 1999 to July 2006 in this hospital were enrolled into the study. A total of 329 cases, 237 primary lung tumors and 92 metastatic tumors, were retrospectively analyzed and evaluated for complications, local progression, and overall survival after one, two, and five years after RFA.
Results: The complications of RFA with surgery included 63 (19.1%) patients with pneumothorax, 14 (4.2%) with hemoptysis (one death), 10 (3.0%) with hemothorax, 15 (4.5%) with pneumonia, and three (0.9%) with pericardial tamponade (one death). The mortality within 30 days was 0.6%. Needle tract tumors were observed in 6 patients (1.8%). The median time for progression was 21.6 months. The overall survival rates at one, two, and five years after RFA were 68.2%, 35.3% and 20.1%, respectively. Up to 78 (23.7%) patients with tumors that exceed 4 cm developed local progression, and a significant difference was found. No significant difference was found among patients with tumors less than 3 cm and among those with 3 cm-4 cm tumors.
Conclusion: RFA is a well-tolerated, reliable, and safe method for the treatment of lung malignancies.
背景与目的: 射频消融（radiofrequency ablation, RFA）是近年来用于无法手术的肺部恶性肿瘤及肺转移瘤治疗的替代方案。本研究旨在评估肺射频消融术的安全性和临床疗效。
方法: 本研究回顾性分析1999年10月-2006年7月在第四军医大学唐都医院胸腔外科进行肺部恶性肿瘤射频消融术的患者329例（其中肺部原发肿瘤237例，转移瘤92例），对其进行射频治疗后的并发症、局部进展以及1年、2年和5年总生存期的临床资料进行了研究及评价分析。
结果: 行射频手术的患者术后出现的并发症包括：气胸63例（19.1%），咯血14例（死亡1例，4.2%），血胸10例（3.0%），肺炎15例（4.5%）和心包填塞3例（死亡1例，0.9%），术后30天内的死亡率为0.6%，针道肿瘤种植的患者6例（1.8%）。中位无进展时间为21.6个月。1年、2年和5年总生存率分别为68.2%、35.3%和20.1%。共有78例（23.7%）患者出现后期肿瘤局部进展。肺部肿瘤原位局部进展的患者的肿瘤包块直径大多 > 4 cm; 在肿瘤局部进展方面，肿瘤 < 3 cm的患者与直径介于3 cm-4 cm的肿瘤患者相比没有明显差异，这两组患者与直径 > 4 cm的肿瘤患者间存在明显差异。
结论: 对于肺部恶性肿瘤来说，射频治疗是一种耐受性良好、疗效可靠安全的治疗方法。