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肺癌:微波治疗回顾性研究

时间:2020-03-03 22:53来源:未知 作者:admin 点击:
研究的设计和分析 Primary endpoints Duration of patient follow-up (date of ablation to last known chest CT or PET/CT) Primary and secondary technical success rate Time to first recurrence/local control rate All-cause and cancer specific mort



研究的设计和分析

Primary endpoints

Duration of patient follow-up (date of ablation to last  known chest CT or PET/CT)
Primary and secondary technical success rate
Time to first recurrence/local control rate
All-cause and cancer specific mortality

Immediate and delayed complications

Pneumothorax, hospital admission, pain, infection,  acute respiratory distress syndrome (ARDS),  bronchopleural fistula (BPF), and post-ablation  syndrome
 

Patient Demographics

 - November 2003 – March 2013
 - Eligibility: solitary parenchymal mass treated for local  control
 - 108 patients (42 female, 66 male, mean age 72.5 ± SD  10.3) underwent MWA for a single lung malignancy  under CT guidance
       - All patients deemed medically inoperable (n=105) or  refused surgery (n=3)
 - 108 tumors
       82 primary lung cancers
       24 metastases (9 colorectal, 2 renal cell carcinoma, 2 sarcoma, 9 other)
 - Mean tumor diameter of 3 cm
 

Local Control

Median duration of imaging follow up = 14.1 months [10,17]
      -55% at 1 yr, 24 % at 2 yrs, and 12% at 3 yrs
Median time to local recurrence for technical success = 39.7  months [20, na]
Local control 75% at 1 yr, 59% at 2 yrs, and 40% at 40 months



here was a significant difference (p=0.002) in the  recurrence rate for size >3 cm (17.6 months [6.6,  na]) and <3 cm (62.1 months [28.9, na]).



 

Survival for all patients

Median all-cause time to death for all patients = 27.1 months [20, 40.5]
      78% at 1 yr, 54% at 2 yrs, 39% at 35 months
Median cancer-specific time to death for all patients = 42.2 months [33,na]
      88% at 1 yr, 75% at 2 yrs, 60% at 41 months  

All-cause Mortality

Cancer-specific Mortality



- For patients that achieved technical success, there was a significant  difference (p=0.004) in cancer related survival for tumor size >3 cm (40.9  months [18.9, na]) vs. <3 cm (60.3 months [32.9, na])
- The difference in all-cause survival approached significance (p=0.06), with  a median time to death for tumor size >3 cm of 20.3 months [13.6, 40.9]  vs. <3 cm of 33 months [24.5, 60.3].

All-cause Mortality


Cancer-specific Mortality
 

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