Radiology:结直肠癌肺转移射频消融后的3年生存率有多高?

2020-04-10 shaosai MedSci原创

尽管射频消融术(RFA)已被广泛用于结直肠癌(CRC)肺转移的治疗中,但其与手术切除相比的效能尚不明确。

背景

尽管射频消融术(RFA)已被广泛用于结直肠癌(CRC)肺转移的治疗中,但其与手术切除相比的效能尚不明确。

目的

本研究旨在评价可切除性CRC肺转移患者经RFA治疗的预后。

材料与方法

本研究纳入了CRC肺转移且转移灶数量≤5、直径≤3个的患者。CRC患者共有100处肺转移,大小范围约0.4-2.8 cm (mean, 1.0 cm ± 0.5),进行了88次的RFA。主要研究结果为3年整体生存(OS)率,预期达到55%;次要结果为局部病灶的进展率和安全性。利用Kaplan-Meier法生成OS率。利用Log-rank检验和COX比例风险回归模型识别预后相关指标。根据CMCAE进行评价不良事件。

结果

本研究共纳入了77例CRC的患者。3年OR率为84% (59/70例; CI: 76%, 93%)。在多变量分析中,与OS较差相关的指标为原发肿瘤位于直肠(HR = 7.7; 95% CI: 2.6, 22.6; P < .001),、癌胚抗原阳性(HR = 5.8; 95% CI: 2.0, 16.9; P = .001)、无化疗史(HR = 9.8; 95% CI: 2.5, 38.0; P < .001)。共有6/70例(9%)患者出现局部肿瘤进展。5级不良事件仅在1/88次RFA(1%)中出现,2级不良事件在18次RFA (20%)中出现。

结论

对于可切除性结直肠癌肺转移(≤3cm)的患者来说,肺射频消融能够获得3年整体生存期高达84%

原始出处:

Hasegawa T, Takaki H, Kodama H.et al. Three-year Survival Rate after Radiofrequency Ablation for Surgically Resectable Colorectal Lung Metastases: A Prospective Multicenter Study.DOI:10.1148/radiol.2020191272

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结直肠癌(CRC)作为全球第三大常见癌症,也是中国第四大常见的死亡因素。既往研究表明,少数癌细胞能够表达干细胞标志物,并产生具有促进肿瘤恶性进展的类干细胞特性。