Abstract

Purpose

This retrospective study aimed to evaluate the safety and efficacy of microwave ablation (MWA) for lung malignancies in patients with severe emphysema.

Materials and methods

The clinical records of 1075 consecutive patients treated for malignant lung tumors in our department were retrospectively reviewed. Emphysema was assessed based on standard-dose computed tomography (CT) and was considered severe when it occupied ≥25% of the lung. Overall, 26 patients (24 men and 2 women; mean age ± standard deviation [SD]: 71.23 ± 8.18 years, range: 59–88 years) with severe emphysema underwent CT–guided percutaneous MWA for treating 26 tumors (24: non-small cell lung cancer and 2: metastases). The mean tumor size was 3.0 cm (SD: 1.5, range: 1.2–6.5 cm). Follow-up was performed with CT at 1, 3, 6, 12 months after ablation, and every 6 months thereafter. Complications and efficacy were evaluated.

Results

The median follow-up duration in all patients was 17.5 months (range: 5–37 months, interquartile range: 15.8). The mortality rate was 0% within 30 days after ablation. Major complications including pneumonia, lung abscess and refractory pneumothorax occurred in 19.2% (5/26) patients. The technical success and efficacy rates were 88.5% (23/26) and 87.0% (20/23), respectively, and the local tumor progression rate was 30.0% (6/20).

Conclusion

MWA appears to be a safe and effective therapeutic option for treating lung malignancies in patients with severe emphysema.

中文翻译：

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微波消融并存严重肺气肿的肺恶性肿瘤：回顾性分析26例患者的安全性和有效性

摘要

目的

这项回顾性研究旨在评估微波消融（MWA）对严重肺气肿患者的肺恶性肿瘤的安全性和有效性。

材料和方法

回顾性分析我科1075例恶性肺部肿瘤患者的临床资料。根据标准剂量计算机断层扫描（CT）评估肺气肿，当肺气肿占肺的≥25％时被认为是严重的。总体上，有26例重度气肿的患者（24例男性和2例女性；平均年龄±标准差[SD]：71.23±8.18岁，范围：59–88岁）接受了CT引导的经皮MWA治疗26例肿瘤（24：非小细胞肺癌和2：转移）。平均肿瘤大小为3.0厘米（标准差：1.5，范围：1.2-6.5厘米）。消融后1、3、6、12个月以及之后每6个月进行CT随访。评估并发症和疗效。

结果

所有患者的中位随访时间为17.5个月（范围：5-37个月，四分位间距：15.8）。消融后30天内死亡率为0％。19.2％（5/26）的患者发生了包括肺炎，肺脓肿和难治性气胸在内的主要并发症。技术成功率和有效率分别为88.5％（23/26）和87.0％（20/23），局部肿瘤进展率为30.0％（6/20）。

结论

MWA似乎是治疗严重肺气肿患者的肺恶性肿瘤的一种安全有效的治疗选择。