[1]邹旭公,李晓群,陈 源,等.C臂CT引导经皮穿刺射频消融治疗不可切除Ⅰa期非小细胞肺癌 [J].介入放射学杂志,2018,27(11):1056-1059.
 ZOU Xugong,LI Xiaoqun,CHEN Yuan,et al.C- arm CT- guided percutaneous radiofrequency ablation for unresectable stage Ⅰa non- small cell lung cancer[J].journal interventional radiology,2018,27(11):1056-1059.
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C臂CT引导经皮穿刺射频消融治疗不可切除Ⅰa期非小细胞肺癌 

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
27
期数:
2018年11期
页码:
1056-1059
栏目:
非血管介入
出版日期:
2018-11-25

文章信息/Info

Title:
C- arm CT- guided percutaneous radiofrequency ablation for unresectable stage Ⅰa non- small cell lung cancer
作者:
邹旭公 李晓群 陈 源 黄大钡 张 健
Author(s):
ZOU Xugong LI Xiaoqun CHEN Yuan HUANG Dabei ZHANG Jian.
Interventional Therapy Center, Zhongshan Municipal People’s Hospital, Zhongshan Affiliated Hospital of Sun Yat- sen University, Zhongshan, Guangdong Province 528403, China
关键词:
【关键词】 C臂CT 非小细胞肺癌 射频消融
文献标志码:
A
摘要:
【摘要】 目的 探讨运用C臂CT引导经皮穿刺射频消融(RFA)治疗不可切除Ⅰa期非小细胞肺癌(NSCLC)的可行性、安全性和有效性。方法 收集2012年3月—2016年3月经病理确诊Ⅰa期NSCLC应用C臂CT引导经皮RFA病例。穿刺精确性、穿刺时间及穿刺调整次数用于评价其可行性,常见不良反应事件评价标准(CTCAE- V4.0)评价其安全性,改良实体肿瘤的疗效评价标准(mRECIST )用于评价其有效性。结果 33例患者共38次RFA,肿瘤长径平均2.3 cm(0.9~3 cm),中位穿刺时间平均12 min(5~28 min)。中位穿刺调整次数平均4次(3~6次),穿刺精确性为(3±0.3) mm(0~9 mm),并发症包括气胸4例(grade2),咯血2例(grade2)。33例患者RFA治疗后的1年、2年总生存率为84.8%、75.7%,无瘤生存率为63.6%、45.5%;手术平均累积剂量和平均有效剂量分别为14 377.8 μGy×m2和24.3 mSv。结论 C臂CT引导经皮穿刺RFA治疗不可切除Ⅰa期NSCLC具有较高可行性和安全性;近中期有效性确切,是一种可供选择的影像引导方式。

参考文献/References:

[1] 刘宝东, 叶 欣, 范卫君, 等. 影像引导射频消融治疗肺部肿瘤专家共识(2018年版)[J]. 中国肺癌杂志, 2018, 21: 76- 88.
[2] Dupuy DE, Fernando HC, Hillman S, et al. Radiofrequency ablation of stage ⅠA non- small cell lung cancer in medically inoperable patients: results from the American College of Surgeons Oncology Group Z4033(Alliance) trial[J]. Cancer, 2015, 121: 3491- 3498.
[3] 方良毅, 陈晓明, 金浩生, 等. 多层螺旋CT多平面重建技术在肝癌射频消融术中的应用[J]. 介入放射学杂志, 2016, 25: 425- 430.
[4] Choo JY, Park CM, Lee NK, et al. Percutaneous transthoracic needle biopsy of small(≤ 1 cm) lung nodules under C- arm cone- beam CT virtual navigation guidance[J]. Eur Radiol, 2013, 23: 712- 719.
[5] 黄大钡, 李晓群, 张 健, 等. C臂CT在肺小结节胸腔镜切除术前定位中的应用[J]. 介入放射学杂志, 2017, 26: 843- 846.
[6] Lee SM, Park CM, Lee KH, et al. C- arm cone- beam CT- guided percutaneous transthoracic needle biopsy of lung nodules: clinical experience in 1108 patients[J]. Radiology, 2014, 271: 291- 300.
[7] Amouyal G, Dernot S, Dean C, et al. Percutaneous radiofreguenay ablation of lung metastases from colorectal careinoma under C- arm cone beam CT guidance[J]. Diagn Interv imaging, 2017, 98: 793- 799.
[8] Liu B, Liu L, Hu M, et al. Percutaneous radiofrequency ablation for medically inoperable patients with clinical stageⅠnon- small cell lung cancer[J]. Thorac Cancer, 2015, 6: 327- 333.
[9] Huang BY, Li XM, Song XY, et al. Long- term results of CT- guided percutaneous radiofrequency ablation of inoperable patients with stageⅠa non- small cell lung cancer: a retrospective cohort study[J]. Int J Surg, 2018, 53: 143- 150.
[10] de Baere T, Tselikas L, Catena V, et al. Percutaneous thermal ablation of primary lung cancer[J]. Diagn Interv Imaging, 2016, 97: 1019- 1024.
[11] 李晓群, 张 勇, 黄大钡, 等. C臂CT在15例肺部小病灶射频消融术中的应用[J]. 介入放射学杂志, 2013, 22: 67- 70.
[12] 黄郭灏, 任建庄, 段旭华, 等. C臂CT引导经皮乙醇消融术在巨块型肝癌经肝动脉化疗栓塞后的近期疗效[J]. 介入放射学杂志, 2015, 24: 41- 45.
[13] Cazzato RL, Battistuzzi JB, Catena V, et al. Cone- beam computed tomography(CBCT) versus CT in lung ablation procedure: which is faster?[J]. Cardiovasc Intervent Radiol, 2015, 38: 1231- 1236.
[14] Tsalafoutas IA, Tsapaki V, Triantopoulou C, et al. CT- guided interventional procedures without CT fluoroscopy assistance: patient effective dose and absorbed dose considerations[J]. AJR Am J Roentgenol, 2007, 188: 1479- 1484.
[15] Gupta R, Grasruck M, Suess C, et al. Ultra- high resolution flat- panel volume CT: fundamental principles, design architecture, and system characterization[J]. Eur Radiol, 2006, 16: 1191- 1205.
[16] Higashihara H, Osuga K, Azuma T, et al. Detection of pulmonary nodules by C- arm CT using a phantom lung: comparison with CT[J]. Acta Radiol, 2011, 52: 964- 968.
[17] Zhu JC, Yan TD, Morris DL. A systematic review of radiofrequency ablation for lung tumors[J]. Ann Surg Oncol, 2008, 15: 1765- 1774.
[18] Baba Y, Watanabe M, Yoshida N, et al. Radiofrequency ablation for pulmonary metastases from gastrointestinal cancers[J]. Ann Thorac Cardiovasc Surg, 2014, 20: 99- 105.
[19] 王永红, 李家开, 张 肖. CT引导下经皮穿刺肺活检术并发症分析[J]. 中国介入影像与治疗学, 2010, 7: 140- 143.

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备注/Memo

备注/Memo:
(收稿日期:2018-03-30)
(本文编辑:俞瑞纲)
更新日期/Last Update: 2018-11-16