Clinical Study Of Radiofrequency Ablation For Subcentimeter GGN Non-small-cell Lung Carcinoma

?Objectives?Retrospective analysis on subcentimeter GGN non-small-cell lung carcinoma: its feasibility,security and validity of double needle combined with CT guided percutaneous radiofrequency ablation directed by acupuncture manipulation.?Methods?From March 2011 to June 2018,a total of 22 patients with sub-cm GGN non-small cell lung cancer who could not be surgically removed or refused surgery were treated with radiofrequency ablation total twenty-five times.Because the sub-cm GGN lesions are small and the density is close to the normal lung tissue,it is difficult to reach the predetermined target accurately.This group adopts the puncture technique of CT-guided and needle-based method,which greatly improves the accuracy of the hit target.The average diameter of the lesions in this group was 8.8 mm(8.4-9.6).The ablation was performed with a single-pole needle.The conventional ablation power was 50 W,and the average ablation time was 8 min(5 to 12.5 min).The intraoperative and postoperative complications were collected,overall survival rate and local progression-free survival rate were observed in 5 years.According to whether the lesions contained solid components,the study was divided into two groups,the pure ground glass malignant tumor group and the sub-solid malignant tumor group.The overall survival rate and local tumor recurrence were compared between the two groups.?Results?All patients accepted successful RFA with ablation and death in the perioperation period.The most common complications is pneumothorax in 9 cases(40.9%)without any other severe complications.During the 54 months follow-up sur vey,there were 3 cases with local recurrence,4 death with non-tumor factors,1case lost.The 1-,2-,3-,4-,5-,overall survival rate were 100%,95.5%,86.4%,77.3%,77.3% and the 1-,2-,3-,4-,5-,local progression-free survival rate wer e 95.5%,86.4%,86.4%,86.4%? 86.4%.The overall survival rates of the purely gro und glass malignant tumor group and the subsolid malignant tumor group at th e 1st,2nd,3rd,4th,and 5th year were 100% and 100%,100% and 95.5%,95.5% and 90.9%,90.9% and 86.4 %,90.9% and 86.4% respectively;P=0.3098,the difference was not statistically significant;local progression-free survival rates a t the 1st,2nd,3rd,4th,and 5th year were 100% and 95.5%,95.5% and 84.6%,95.5% and 84.6%,95.5% and 84.6%,95.5% and 84.6% respectively;P=0.78,the difference was not statistically significant.?Conclusion?Double needle method combined with CT guided percutaneous radiofrequen cy ablation is a safe and effective local treatment for sub-centimeter GGN nonsmall cell lung cancer patients who cannot be surgically removed or refused sur gery.