抄録
Since 2002, we have applied percutaneous cryoablation for lung tumors (PCLT) under intermittent CT fluoroscopic guidance. In this paper, we describe our experience of PCLT more than 100 cases with about 300 primary or secondary tumors. The procedure was well tolerated by all patients. One-, 2- and 3-year local progression-free rates were 80.4%, 69.0% and 67.7%, respectively. Existence of a thick vessel (diameter ≥3mm) ≤3 mm from the edge of the tumor (P=.003) was assessed as an independent factor associated with local progression by multivariate analysis. Of 193 sessions pneumothorax, pleural effusion, and hemoptysis occurred after 119(61.7%), 136(70.5%), and 71(36.8%) sessions, respectively.
Of all cases with pneumothorax, 17.6% required chest tube insertion and 1.7% required pleurodesis. Delayed and recurrent pneumothorax occurred in 7.8% each. A greater number of cryoprobes was a significant predictor of pneumothorax (P<.001). Male sex (P=.047) and no history of ipsilateral surgery (P=.012) were predictors for the need for chest tube insertion, and no history of ipsilateral surgery (P=.021) was a predictor for delayed/recurrent pneumothorax. The Common Terminology Criteria for Adverse Events (CTCAE) grade 4 and 5 complications were not observed.
The biggest advantage compared with RFA is painlessness in PCLT. In addition, multiple cryoprobe activation is possible in PCLT. One of the drawbacks of PCLT is the difficulty of the PCLT procedure compared with RFA. PCLT could be performed minimally invasively with acceptable rates of local control.
