[Radiofrequency Ablation for Lung Ground-glass Nodule]

Abstract

Background: With the wide application of computed tomography (CT) in the screening of early lung cancer, more and more ground glass nodules (GGNs) have been found. Early intervention is helpful to improve the survival rate of lung cancer patients. Radiofrequency ablation (RFA) is an alternative option to manage primary or metastatic lung malignancies. The purpose of this study is to review the safety and clinical efficacy for lung GGN treated by RFA.

Methods: From June 2016 to March 2021, 24 patients with a total of 28 lung GGNs in our hospital underwent 28 sessions of RFA. There were 13 males and 11 females with an average age of (69.4±11.1) years. The size of GGN receiving RFA was (1.30±0.56) cm; The ablation range was (2.50±0.63) cm and ablation time was (15.00±8.68) min.

Results: The procedure of all RFAs went smoothly, no perioperative deaths occurred and no serious complications during the operation. The median follow-up was 25 months. One case died of myocardial infarction 2 months after operation. All 28 GGNs showed no evidence of local progression and the local control rate was 100.0%. Kaplan-Meier analysis showed that the 1-year and 2-year overall survival rates were 95.8% and 95.8%; the tumor specific survival rates were 100.0% and 100.0%, respectively.

Conclusions: RFA is a safe, effective and minimally invasive technique for the treatment of lung GGNs.

Keywords: Clinical effective; Lung ground-glass nodule; Radiofrequency ablation.

1

78岁女性，CT发现右肺上叶GGN，组织学病理证实为腺癌。A：射频消融前的CT图像显示右上肺有一个直径2.0 cm的GGN；B：CT透视RFA过程中的图像显示电极被插入GGN；射频消融后10.2个月（C）和26.5个月（D）的CT图像显示消融肿瘤消退，表明完全消融。 Right upper lobe GGN was detected on CT in an 78-year-old woman, histologically confirmed as adenocarcinoma. A: CT image before RFA in the lung window setting shows a tumor, 2.0 cm in diameter, located in the right upper lobe; B: CT images shows that a electrode is introduced into the tumor; 10.2 months (C) and 26.5 months (D) after RFA in the lung window setting shows that the tumor was well controled. CT: computed tomography; RFA: radiofrequency ablation.

2

消融前后GGN的CT影像变化。A：消融前GGN；B：消融后肿瘤周围出现GGO，CT上靶区轮廓变得不清晰。 Comparison of CT images of GGNs before and after RFA. A: The image of GGN before RFA was performed; B: The tumor was covered by the GGO after RFA, and the contour of the target area becomes unclear on CT. GGO: ground-glass opacity.