Background: Primary lung cancer is one of the most common malignancies worldwide. Surgical resection remains the first choice for the treatment of early stage non-small cell lung cancer (NSCLC). Relapse after surgery sharply reduces the patient's life expectancy. This relapse is referred to as isolated postsurgical local recurrences or metastases (IPSLROM), which can be treated via local therapy to achieve long-term survival or cure. In recent years, radiofrequency ablation (RFA) has been increasingly used as a non-surgical treatment option for patients with primary and metastatic lung tumors. This study aims to evaluate the efficacy of RFA among patients with IPSLROM of NSCLC.
Methods: A total of 20 patients underwent computerd tomograghy (CT)-guided RFA for lung neoplasm with IPSLROM of NSCLC (with unresectable disease because of poor lung reserve or multifocality) in our hospital between December 2008 and November 2013. These patients comprised 15 males and 5 females with a mean age of 69.2 years (range: 45-85). All patients exhibited pathological evidence of neoplastic lesion (14 tumors were adenocarcinoma, and six were squamous cell carcinoma). The mean size of the lesions was 3.9 cm (range: 2.0 cm to 8.0 cm). Treatment complications, progression-free survival (PFS), and survival parameters were retrospectively analyzed.
Results: RFA was well tolerated by all patients with an average time of 34.3 min (range: 15 min to 60 min). Intraprocedural complications included eight cases of chest pain (40%). No procedure-related deaths occurred in all of the 20 ablation procedures. The median PFS was 25 months in all of the patients who received RFA. The median overall survival for the entire group of patients was 27.0 months. No differences were observed in the overall survival between patients with IPSLROM. The overall survival rates at 1 and 2 years after RFA were 92.9% and 57.0%, respectively.
Conclusions: RFA is a safe and effective procedure in unresectable lung tumors with IPSLROM of NSCLC.
背景与目的 肺癌是最常见的恶性肿瘤之一，外科手术仍是早期非小细胞肺癌的首选治疗手段，然而术后复发降低了患者的生存预期。但是部分患者如局部复发或孤立性肺内转移通过局部治疗可以延长生存甚至治愈。射频消融术（radio-frequency ablation, RFA）成为一种不适合手术治疗的原发性或转移性肺肿瘤的新的局部治疗手段。本研究的目的是评价非小细胞肺癌切除术后肺内孤立性复发转移灶的治疗效果。方法 2008年12月-2013年11月对20例肺癌切除术后不能再次手术的孤立性肺内转移复发灶进行CT引导下射频消融术。男性15例，女性5例，年龄45岁-85岁，平均69.2±11.6岁。全组病例均有病理学证实（腺癌14例、鳞癌6例）。病灶直径最小2.0 cm，最大8.0 cm，平均3.9±2.0 cm。对其并发症、无进展生存（progression-free survival, PFS）和总生存期进行回顾性分析。结果 全组病例均能完成射频消融术，平均消融时间为34.3 min（15 min-60 min），术中常见的并发症是胸痛8例（40%），无围术期死亡。中位PFS为25.0个月；中位生存时间27.0个月，1年生存率为92.9%，2年生存率为57%。结论 RFA对非小细胞肺癌术后不能耐受再次手术的肺内孤立性转移复发安全可行。