Percutaneous Ultrasound-guided Radiofrequency Ablation of Colorectal Liver Metastases

本研究是評估超音波導引下經皮熱射頻滅除術治療大腸直腸肝轉移癌的臨床應用治療效果，以及併發症。從2002年1月到2004年12月，共有63位病人（39位男性與24位女性），109個大腸直腸肝轉移癌，接受超音波導引下經皮熱射頻滅除術治療腫瘤。這些病人的平均年齡是65.3歲（37-89歲），平均腫瘤大小是2.9公分（1.2-5.0公分）。本研究的病人其腫瘤數介於1-3個，且每一個腫瘤大小不超過5公分。治療後1個月以動態電腦斷層評估其治療效果，然後每隔3個月追蹤。腫瘤完全壞死的定義是在電腦斷層上被治療的腫瘤呈現低密度且完全沒有顯影。治療後動態電腦斷層攝影顯示78.9% (86/109)的腫瘤完全壞死，而21.1% (23/109)仍有殘存的腫瘤。以腫瘤大小來評估其效果，小於2公分腫瘤的壞死率100% (24/24)，2-3公分腫瘤的壞死率是90.2% (37/41)，3-4公分腫瘤的壞死率是 64.3% (18/28)，4-5公分腫瘤的壞死率是43.7% (7/16)。治療後有3位病人有嚴重的併發症，其中2位有肝膿瘍，1位有膽汁鬱積。平均的追蹤時間是22.4個月（4-40個月），有13.8% (15/109)的腫瘤在追蹤期有腫瘤復發的情形。經皮熱射頻滅除術可以有效的治療大腸直腸肝轉移癌，尤其是小於3公分的腫瘤效果最好，3-4公分的腫瘤的療效也還可以，治療後產生的嚴重併發症的比例也很低。

關鍵字

肝臟腫瘤，轉移；肝臟腫瘤，治療；熱射頻滅除術

並列摘要

The objective of this study is to analyze the efficacy, side effects, and complications of percutaneous radiofrequency ablation (RFA) performed tinder ultrasound guidance in 63 patients with 109 colorectal liver metastases. Between January 2002 to December 2004, 63 patients (39 male and 24 female) with 109 hepatic metastases from colorectal cancer were treated with RFA. The mean age of the patients was 65.3 years old (range, 34-89 years), and the mean tumor diameter was 2.9 cm (range, 1.2 to 5.0 cm). Inclusion criteria for the procedure were defined for patients with no more than three metastases and none of which were larger than 5cm in diameter. The efficacy of RFA was evaluated with biphasic contrast enhanced CT performed one month after the procedure, and then every three months. Complete necrosis was defined as hypoattenuation areas without contrast enhancement in the treated region on the follow-up CT studies. Posttreatment CT showed complete necrosis in 86 of 109 (78.9%) colorectal liver metastases after one session of RFA treatment, and residual tumors were observed in 21.1% (23/109) tumors. Complete necrosis based on tumor size was seen in 100% (24/24) tumors with diameters equal to or smaller than 2 cm, 90.2% (37/41) tumors with diameter between 2.1 and 3.0 cm, 64.3% (18/28) tumors between 3.1 and 4.0 cm, and 43.7% (7/16) tumors between 4.1 and 5.0cm. The major complications after treatment were abscess (two patients) and biloma (one patient). The length of the follow tip period ranged from 4 to 40 months (mean, 22.4 months). During the follow-up period, 13.8% (15/109) metastases showed a local recurrence on the basis of CT findings. RFA appears to be a promising therapeutic modality for the treatment of hepatic metastases from colorectal carcinoma, especially for those tumors no more than 3 cm in greatest diameter; and has a satisfactory success rate in tumors of 3 to 4 cm. The rate of serious complications of RFA is low. Further studies are necessary to determine the long-term efficacy of RFA in colorectal liver metastases.

並列關鍵字

Liver neoplasms, metastases ； Liver neoplasms, therapy ； Radiofrequency RF ablation

國際替代計量

Percutaneous Ultrasound-guided Radiofrequency Ablation of Colorectal Liver Metastases

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