经导管动脉栓塞联合微波消融治疗肾癌的初步疗效分析

doi:10.19558/j.cnki.10-1020/r.2021.02.009

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摘要 目的： 探讨经导管动脉栓塞（TAE）联合微波消融（MWA）治疗肾细胞癌（RCC）的初步疗效、可行性及安全性。方法： 回顾性分析2013年9月–2020年4月16例接受TAE联合MWA治疗且资料完整、经病理确诊的RCC患者的临床资料。16例患者首先接受TAE治疗,然后在Dyna CT引导下行MWA。比较治疗前后的实验室指标变化。治疗后1、3、6个月复查增强CT/MRI评价疗效,必要时巩固治疗。观察、记录不良反应及并发症发生情况、生存时间。随访8.9~36.8个月。结果： 手术成功率为100%。治疗前后尿常规、肾功能均无显著变化。术后仅出现一过性不良反应,对症治疗后均得到缓解,无严重并发症发生。术后1、3、6个月完全缓解率分别为93.8%（15/16）、93.8%（15/16）、81.2%（13/16）,部分缓解率分别为6.2%（1/16）、6.2%（1/16）、18.8%（3/16）,客观缓解率均为100%。中位生存期为31.6个月,6、12、18、24个月总生存率分别为100%、92.3%、76.9%、76.9%。结论： TAE联合MWA治疗RCC技术安全可行,可有效控制肿瘤进展,近期疗效肯定。

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	李臻
	纪坤
	王彩鸿
	李鑫
	詹鹏超
	石洋
	韩新巍

关键词 ：经导管动脉栓塞术, 微波消融, 肾癌, 介入治疗

Abstract：Objective： To investigate the efficacy, safety and feasibility of transcatheter arterial embolization （TAE） combined with percutaneous microwave ablation （MWA） for the treatment of renal cell carcinoma （RCC）. Methods： The data of 16 patients with RCC who underwent TAE combined with MWA in our department from Sept. 2013 to Apr. 2020 were analyzed retrospectively. All patients were diagnosed as RCC pathologically before the operation. The patients were first treated with TAE and then underwent MWA under the guidance of DynaCT. The differences in laboratory examinations pre- and post-procedure were evaluated. In addition, 1, 3 and 6 months after treatment, enhanced CT/MRI was performed to assess the therapeutic efficacy respectively, and consolidation treatment was carried out if necessary. Adverse reactions and overall survival （OS） were recorded. The follow-up period was 8.9 to 36.8 months. Results： All patients underwent TAE and MWA successfully. There were no significant differences （P > 0.05） in laboratory tests pre- and post-procedure. The patients experienced different degrees of postoperative reactions but got relieved after symptomatic treatment. At 1-, 3- and 6-month follow-up CT/MRI revealed complete release at 93.8% （15/16）, 93.8% （15/16） and 81.2% （13/16） respectively, and partial release at 6.2% （1/16）, 6.2% （1/16） and 18.8% （3/16） respectively, with the objective response rate of 100%. The median OS was 31.6 months. The total survival rates at 6th, 12th, 18th and 24th month were 100%, 92.3%, 76.9% and 76.9% respectively. Conclusion： TAE combined with MWA is safe and feasible as an alternative of RCC. It can effectively control tumor progression of patients with RCC.

Key words： transcatheter arterial embolization microwave ablation renal cell carcinoma interventional therapy

收稿日期: 2020-07-01

基金资助:国家自然科学基金资助项目（U1904143）

通讯作者: 李臻,lzjrfs620@163.com

引用本文:

李臻, 纪坤, 王彩鸿, 李鑫, 詹鹏超, 石洋, 韩新巍. 经导管动脉栓塞联合微波消融治疗肾癌的初步疗效分析[J]. 微创泌尿外科杂志, 2021, 10(2): 118-122.
LI Zhen, JI Kun, WANG Caihong, LI Xin, ZHAN Pengchao, SHI Yang, HAN Xinwei. Efficacy of transcatheter arterial embolization combined with percutaneous microwave ablation in treatment of renal cell carcinoma. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2021, 10(2): 118-122.

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[1] UHLIG J, STRAUSS A, RÜCKER G, et al. Partial nephrectomy versus ablative techniques for small renal masses: a systematic review and network meta-analysis. Eur Radiol, 2019,29(3):1293-1307.
[2] XU Z, XIE H, ZHOU L, et al.The combination strategy of transarterial chemoembolization and radiofrequency ablation or microwave ablation against hepatocellular carcinoma. Anal Cell Pathol (Amst), 2019:8619096.
[3] 张肖,肖越勇,李成利,等.影像学引导肾癌冷冻消融专家共识2019版.中国介入影像与治疗学,2019,16(2):65-70.
[4] GEIGER S, KOCHER N, ILLINSKY D, et al.Comparison of the comprehensive complication index and Clavien-Dindo systems in predicting perioperative outcomes following radical nephroureterectomy. Transl Androl Urol, 2020,9(4):1780-1785.
[5] 中国临床肿瘤学会指南工作委员会.肾癌诊疗指南2020版.北京:人民卫生出版社,2020:36-38
[6] LIONBERG A, JEFFRIES J, VAN HT.Renal artery embolization for neoplastic conditions. Semin Intervent Radiol, 2020,37(4):420-425.
[7] KARALLI A, GHAFFARPOUR R, AXELSSON R, et al.Transarterial chemoembolization of renal cell carcinoma: a prospective controlled trial. J Vasc Interv Radiol, 2017,28(12):1664-1672.
[8] 张宏伟,刘斌,党强,等.后腹腔镜下射频消融与肾部分切除术治疗小肾癌效果比较.中华实验外科杂志,2020,3(3):558-560.
[9] FILIPPIADIS DK, GKIZAS C, CHRYSOFOS M, et al.Percutaneous microwave ablation of renal cell carcinoma using a high power microwave system: focus upon safety and efficacy. Int J Hyperthermia, 2018,34(7):1077-1081.
[10] ZHOU W, ARELLANO RS.Thermal ablation of T1c renal cell carcinoma: a comparative assessment of technical performance, procedural outcome, and safety of microwave ablation, radiofrequency ablation, and cryoablation. J Vasc Interv Radiol, 2018,29(7):943-951.
[11] CHOI SH, KIM JW, KIM JH, et al.Efficacy and safety of microwave ablation for malignant renal tumors: an updated systematic review and Meta-Analysis of the literature since 2012. Korean J Radiol, 2018,19(5):938-949.
[12] PICKERSGILL NA, VETTER JM, KIM EH, et al.Ten-Year experience with percutaneous cryoablation of renal tumors: tumor size predicts disease progression. J Endourol, 2020,34(12):1211-1217.
[13] YU J, ZHANG X, LIU H, et al.Percutaneous microwave ablation versus laparoscopic partial nephrectomy for cT1a renal cell carcinoma: a propensity-matched cohort study of 1955 patients. Radiology, 2020,294(3):698-706.
[14] GAO Y, LIANG P, YU X, et al.Microwave treatment of renal cell carcinoma adjacent to renal sinus. Eur J Radiol, 2016,85(11):2083-2089.
[15] SOMMER CM, KOCH V, PAP B, et al.Effect of tissue perfusion on microwave ablation: experimental in vivo study in porcine kidneys. J Vasc Interv Radiol, 2011,22(12):1751-1757.
[16] ZHOU W, HERWALD SE, MCCARTHY C, et al.Radiofrequency ablation, cryoablation, and microwave ablation for T1a renal cell carcinoma: a comparative evaluation of therapeutic and renal function outcomes. J Vasc Interv Radiol, 2019,30(7):1035-1042.
[17] SALAGIERSKI M, WOJCIECHOWSKA A, ZAJĄC K, et al. The role of ablation and minimally invasive techniques in the management of small renal masses. Eur Urol Oncol, 2018,1(5):395-402.
[18] 吕天石,王灏琛,王健,等.经导管肾动脉化疗栓塞联合射频消融术治疗肾癌的疗效分析.中国介入影像与治疗学,2017,14(5):261-265.
[19] 穆梦娟,于杰,梁萍,等.超声引导经皮微波消融治疗小肾癌的长期疗效观察.南方医科大学学报,2016,36(5):622-627,632.