目的:本研究的目的是前瞻性比较微波(MWA)和射频消融(RFA)使用双重消融系统治疗肝转移的疗效和安全性。
方法:50例肝转移患者(23例男性,平均年龄:62.8±11.8岁)被随机分配到MWA或RFA,使用单消融仪双重消融系统进行热消融。在治疗前和消融后24小时采集磁共振成像(MRI)。对尺寸的治疗的形态学反应,volume,坏死区,和扩散特征通过MRI评估。影像学随访为期一年,间隔三个月,而所有患者均获得了两年的临床随访。
结果:26例患者接受MWA,24例患者接受RFA(平均直径:1.6cm,MWA:1.7厘米,RFA:1.5厘米)。消融后24h的平均体积为37.0cm3(MWA:50.5cm3,RFA:22.9cm3,P<0.01)。MWA组的局部复发率为0%(0/26),RFA组为8.3%(2/24)(P=0.09)。两组新发展的恶性形成率为38.0%(19/50)(MWA:38.4%,RFA:37.5%,P=0.07)。2年后总生存率为70.0%(35/50)(MWA:76.9%,RFA:62.5%,P=0.60)。无重大并发症报告。
结论:结论:MWA和RFA都是治疗肝转移的安全有效的方法,MWA产生更大的消融量。总生存率无显著差异,肿瘤发生率,或两组之间的主要并发症。
OBJECTIVE: The aim of this
study was to prospectively compare the therapy response and safety of microwave (MWA) and radiofrequency ablation (RFA) for the treatment of liver metastases using a dual ablation system.
METHODS: Fifty patients with liver metastases (23 men, mean age: 62.8 ± 11.8 years) were randomly assigned to MWA or RFA for thermal ablation using a one generator dual ablation system. Magnetic resonance imaging (MRI) was acquired before treatment and 24 h post ablation. The morphologic responses to treatment regarding size, volume, necrotic areas, and diffusion characteristics were evaluated by MRI. Imaging follow-up was obtained for one year in three months intervals, whereas clinical follow-up was obtained for two years in all patients.
RESULTS: Twenty-six patients received MWA and 24 patients received RFA (mean diameter: 1.6 cm, MWA: 1.7 cm, RFA: 1.5 cm). The mean volume 24 h after ablation was 37.0 cm3 (MWA: 50.5 cm3, RFA: 22.9 cm3, P < 0.01). The local recurrence rate was 0% (0/26) in the MWA-group and 8.3% (2/24) in the RFA-group (P = 0.09). The rate of newly developed malignant formations was 38.0% (19/50) for both groups (MWA: 38.4%, RFA: 37.5%, P = 0.07). The overall survival rate was 70.0% (35/50) after two years (MWA: 76.9%, RFA: 62.5%, P = 0.60). No major complications were reported.
CONCLUSIONS: In conclusion, MWA and RFA are both safe and effective methods for the treatment of liver metastases with MWA generating greater volumes of ablation. No significant differences were found for overall survival, rate of neoplasm, or major complications between both groups.