| 张洲博,王 鹏,李 天,等.微波消融与冷冻消融治疗肺肿瘤的疗效和安全性分析[J].肿瘤学杂志,2025,31(4):299-304. |
| 微波消融与冷冻消融治疗肺肿瘤的疗效和安全性分析 |
| Comparsion of Efficacy and Safety Between Cryoabltation and Microwave Ablation in Treatment of Lung Cancer |
| 投稿时间：2025-01-02 |
| DOI：10.11735/j.issn.1671-170X.2025.04.B004 |
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| 中文关键词: 肺肿瘤 微波消融 冷冻消融 并发症 疗效 |
| 英文关键词:lung neoplasms microwave ablation cryoablation complication efficacy |
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| 中文摘要: |
| 摘 要：［目的］ 对比分析微波消融（microwave ablation，MWA）和冷冻消融（cryoabltation，CA）治疗肺肿瘤的疗效和安全性。［方法］ 回顾性分析127例2018年7月至2023年2月接受MWA（n=64）及CA（n=63）治疗的肺肿瘤患者资料，对比分析两组疗效、并发症发生率、无进展生存期（progression-free survival，PFS）及总生存期（overall survival，OS）的差异，并分析并发症发生的影响因素。［结果］ 中位随访时间为35个月，术后1个月，MWA组、CA组客观缓解率分别为98.2%、95.6%（P=0.444），术后6个月，两组客观缓解率分别为87.3%、91.1%（P=0.542）。CA组肿瘤原位复发率较MWA组低（3.2% vs 14.1%，P=0.029）。CA组、MWA组中位PFS分别为26、24个月，中位OS分别为35、36个月，两组6个月、1年、2年的PFS（P=0.510）和OS（P=0.409）差异均无统计学意义。CA组较MWA组术后疼痛（7.9% vs 34.4%，P<0.001）及术后发热（3.2% vs 18.8%，P=0.005）发生率低，但咯血发生率高（36.5% vs 9.4%，P<0.001）。多因素分析显示，CA较MWA咯血并发症发生率高［比值比（odds ratio，OR）=2.083，P=0.029］，术后疼痛随病灶距胸膜距离增加而减少（OR=0.587，P=0.042），双针消融较单针消融术后疼痛发生率高（OR=4.343，P=0.010）。［结论］ CA和MWA治疗肺肿瘤的疗效均较好，但CA较MWA咯血发生率高，术后疼痛、发热发生率低，且原位复发风险低。 |
| 英文摘要: |
| Abstract： ［Objective］ To compare the efficacy and safety of microwave ablation (MWA) and cryoablation (CA) in treatment of lung cancer. ［Methods］ The clinical data of 127 lung cancer patients treated in the First Hospital of China Medical University from July 2018 to February 2023 were retrospective analyzed， including 64 cases treated with MWA and 63 cases treated with CA. The therapeutic efficacy， incidence of complications， progression-free survival (PFS)， and overall survival (OS) were compared between the two groups， and the influencing factors of complications were also analyzed. ［Results］ The median follow-up time was 35 months. One month after treatment， the objective remission rates of MWA group and CA group were 98.2% and 95.6%， respectively (P=0.444)； 6 months after treatment， the objective remission rates of the two groups were 87.3% and 91.1%， respectively (P=0.542). The in-situ recurrence rate in the CA group was lower than that in the MWA group (3.2% vs 14.1%， P=0.029). The median PFS of CA and MWA was 26 months and 24 months， the median OS of CA and MWA was 35 months and 36 months (all P>0.05)； there was no significant difference in PFS and OS at 6 months， 1 year and 2 years between the two groups (all P>0.05). The CA group had lower rates of postoperative pain (7.9% vs 34.4%， P<0.001) and postoperative fever (3.2% vs 18.80%， P=0.005) than the MWA group， but the incidence of hemoptysis was higher (36.5% vs 9.4%， P<0.001). Multivariate analysis showed that CA was significantly associated with higher incidence of hemoptysis (OR=2.083， P=0.029)； the distance from the lesion to the pleura was associated with postoperative pain (OR=0.587， P=0.042)； and double needle ablation was associated with higher incidence of pain (OR=4.343， P=0.010). ［Conclusion］ Both CA and MWA have good efficacy in treatment of lung cancer， and CA has a higher incidence of hemoptysis than MWA， but a lower incidence of postoperative pain and fever， a lower risk of in-situ recurrence. |
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