| Objective:Patients were admitted to the thoracic department in 307 Hospital of PLA and formed the basis of this study. All patients were presenting with lung cancer and eligible to be treated by radiofrequency ablation(RFA). For this retrospective study, data on patient outcomes were retrieved from medical records. The incidence of complications and prevention methods were summarized and independent risk factors of complications were analyzed. The study aims to reduce the complications and improve the prognosis of these certain patients. Methods:1. From June 2004 to December 2013, 160 hospitalized with NSCLC patients were treated with the RFA therapy. Complications were observed to analyze specific measures in reducing the incidence of complications.2. RFA. We used the Olympus radiofrequency ablation system, which can record data on the treatment process through an online computer, and marked the position of tumor after C T scanning. We inserted the needle into the center of target tumor, and then connected to the RF transmitter with a setting voltage of 250 volts, 60 to 100 degrees centigrade of temperature for 15 to 50 minutes. For smaller tumors(diameter≤3cm), we put the needle into the center of them for RFA. We also inserted the needle into the deepest position of tumors and gradually adjusted the tip until we finished the entire tumors if they were large(diameter > 3cm) and shapeless. After CT scanning again for pneumothorax and bleeding complications, patients were told to lie down for 2 hours.3. A total of 106 eligible study subjects were enrolled from the thoracic department in 307 Hospital of PLA from June 2004 to December 2014. Data on patient demographics, medications administered in hospital, medical history and comorbidity, clinical characteristics at admission, and procedural characteristics were retrieved from medical records. Statistical analysis and plots were performed using SPSS Statistics 17.0. Descriptive statistics are expressed as mean ± standard deviation(SD) for continuous variables; categorical variables are displayed as number and percentage. Data are summarized with medians and twenty- ?fth and seventy- ?fth percentiles when continuous variables had skewed distributions. All analyses were 2 sided and P<0.05 showed that the difference was statistically significant. C hi-square test was used for categorical variables to examine the factors with complications. To identify the independent predictors of complications, while adjusting for the covariates at vario us levels, forward stepwise and logistic regression models were chosen. Result1. 160 cases of lung cancer patients were successfully completed RFA, no intraoperative deaths. After RFA, complications include fever, hemoptysis, chest pain, pneumothorax, pleural effusion, pneumonia, phrenic nerve injury, cavitation. Related complications were improved after symptomatic treatment, all patients can tolerate the treatment.2. The results of logistic regression analysis. Unadjusted for any other factors, the predictors of postoperative complications were FEV1%(p=0.004), tumor size(p=0.001) and number of lesions(p=0.026). After adjustment, FEV1 % <60%(wald=3.859,P=0.049), tumor diameter >3cm(wald=16.964, P=0.001) and ≥2 lesions(wald=4.566, P=0.033) were the independent predictors of postoperative complications, and the OR were 2.944, 7.706 and 3.041, respectively. Conclusion:1. Performance of RFA was effective and safe for patients with lung cancer, also with complications including fever, hemoptysis, chest pain, pneumothorax, pleural effusion, pneumonia, phrenic nerve injury, cavitation.2. FEV1%<60%, tumor diameter>3cm and ≥2 lesions were independently associated with postoperative complications.3. It is very important to control the indicatio ns strictly, and educate patients to quit smoking, improving pulmonary function. The number of lesions more than or equal to two can be treated repeatedly by RFA. The size of tumor which is larger than 3cm can be directly treated with radiotherapy and chemotherapy. When the tumor diameter is reduced, we treat it with RFA. These measures can effectively reduce the incidence of complications after RFA and improve the quality of life of patients. |
