Skip to main content
SpringerLink
Log in

Perkutane laserinduzierte Thermotherapie von Lungenmetastasen: Erfahrungen nach 4-jähriger Anwendung

Percutaneous laser-induced thermotherapy of lung metastases: experience gained during 4 years

  • Perkutane Ablation von Lungenmetastasen
  • Published:
Der Radiologe Aims and scope Submit manuscript

Zusammenfassung

Laserablationen von Lungenmetastasen führen wir seit 4 Jahren durch. Wir berichten nachfolgend über technischen Erfolg, Ablationsergebnisse und Verlaufskontrollen. 30 Patienten mit 42 Lungenmetastasen wurden behandelt. Das Patientenalter lag zwischen 42 und 74 Jahren. Primärtumoren waren in der überwiegenden Zahl der Fälle colorectale Carcinome, HNO-Tumoren und urogenitale Tumoren. Bei 30 Metastasen war die Lasertherapie technisch durchführbar. Bei 14 Metastasen (33%) gelang eine Komplettablation. Bei 8 Metastasen steht die Beurteilbarkeit des Ablationserfolges bei erst kurzer Nachbeobachtungszeit (4–8 Wochen) noch aus.

Generell können zentral lokalisierte Metastasen (im Gegensatz zur vide-assistierten Thorakoskopie—VATS) besser als periphere Metastasen behandelt werden. Um ein gutes Ablationsergebnis zu erzielen, sollte die Metastasengröße nicht über 3 cm im Durchmesser liegen. Die perkutane Ablation von Lungenmetastasen könnte bei einem relativ hohen Prozentsatz nichtoperabler Metastasen als komplikationsarme, minimal-invasive Therapieoption Anwendung finden.

Abstract

We perform laser ablation of lung metastases for four years. In the following we report on technical success, ablation results and follow-up. 30 patients with a total of 42 lung metastases were treated. Patients were aged between 42 and 74 years. Primary tumors were mostly colorectal carcinomas, head and neck and uro-genital tumors. Technical success was achieved in 40, complete ablation in 14 metastases (33%); however, in 8 metastases follow-up was too short for a valid evaluation (4–8 weeks). Further analysis may improve the overall results: Metastases located in the central parts of the lungs were more easily treated than those located peripherally. Best results were achieved in metastases not larger than 3 cm.—Percutaneous ablation of lung metastases has potential as an additional therapeutic option if surgery is not possible.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1a,b
Abb. 2
Abb. 3
Abb. 4
Abb. 5

Literatur

  1. Baron O, Amini M, Duveau D, Despins P, Sagan CA, Michaud JL (1996) Surgical resection of pulmonary metastases from colorectal carcinoma. Eur J Cardio-Thorc Surg 10:347–351

    Google Scholar 

  2. Friedel G, Pastoriino U, McCormack P et al. (1999) Resektion von Lungenmetastasen, Langzeitresultate prognostischer Faktoren auf der Basis von 5206 Fällen. The International Registry of Lung Metastases. Zentralbl Chir 124:96–103

    CAS  PubMed  Google Scholar 

  3. Garcia-Rio F, Pino JM, Casadevall J et al. (1996) Use of spirometry to predict risk of pneumothorax in CT-guided needle biopsy of the lung. J Comput Assisted Tomogr 20:20–23

    Article  CAS  Google Scholar 

  4. Haramati LB, Austin JHM (1991) Complications after CT-guided needle biopsy through aerated versus nonaereted lung. Radiology 181:778

    CAS  PubMed  Google Scholar 

  5. Highland AM, Mack P, Breen DJ (2002) Radiofrequency thermal ablation of metastatic lung nodule. Eur Radiol 12:5166–5170

    Google Scholar 

  6. Hosten N, Stier A, Weigel C et al. (2003) Laser-induzierte Thermotherapie (LITT) von Lungemetastasen: Beschreibung eines Applikators, Optimierung und erste Patientenbehandlungen. ROFO 175:393–400

    Article  CAS  Google Scholar 

  7. Huanqi L, Boiselle PM, Mc Loud TC et al. (1996) Diagnostic accuracy and safety of CT-guided percutaneous needle aspiration biopsy of the lung: comparision of small and large pulmonary nodules. AJR 167:105–109

    PubMed  Google Scholar 

  8. Inoue M, Kotake Y, Nakagawa K et al. (2000) Surgery for pulmonary metastases from colorectal carcinoma. Ann Thorax Surg 70:380–383

    Article  CAS  Google Scholar 

  9. Isbert C, Boerner A, Ritz JP, Schuppan D, Buhr HJ, Germer CT (2002) In situ ablation of experimental liver metastases delays and reduces residual intrahepatic tumour growth and peritoneal tumour spread compared with hepatic resection. Br J Surg 89:1252–1259

    Article  CAS  PubMed  Google Scholar 

  10. Klein JS, Zarka MA (2000) Transthoracic needle biopsy. Radiol Clin North Am 38:235–266

    CAS  PubMed  Google Scholar 

  11. Laurent F, Michel P, Latrabe V et al. (1999) Pneumothoraces and chest tube placement after CT-guided transthoracic lung biopsy using a coaxial technique: incidense and risk factors. AJR 172:1049–1053

    CAS  PubMed  Google Scholar 

  12. Lee JM, Jin GY et al. (2004) Percutaneous radiofrequency ablation for inoperable non-small cell lung cancer and metastases: preliminary report. Radiology 230:125–134

    PubMed  Google Scholar 

  13. Leo F, Cagini L, Rocmans et al. (2000) Lung metastases from melanoma: when is surgical treatment warranted? Br J Cancer 83:569–572

    Article  CAS  PubMed  Google Scholar 

  14. McCormack PM, Attizeh FF (1979) Resected pulmonary metastases from colorectal cancer. Dis Colon Rectum 22:533–556

    Google Scholar 

  15. McCormack PM, Burt ME, Bains MS, Martini N, Rusch VW, Ginsburg RJ (1992) Lung resection for colorectal metastases. 10-year results. Arch Surg 127:1403–1406

    CAS  PubMed  Google Scholar 

  16. Puls R, Stroszczynski C, Gaffke G, Hosten N, Felix R, Speck U (2003) Laser-induced thermotherapy (LITT) of liver metastases: MR-guided percutaneous insertion of an MRI-compatible irrigated microcatheter system using a closed high-field unit. J Magn Reson Imaging 17:663–670

    Article  PubMed  Google Scholar 

  17. Rose SC, Fotooki M et al. (2002) Cerebral microembolization during radiofrequency ablation of lung malignancies. J Vasc Interv Radiol 13:1051–1054

    PubMed  Google Scholar 

  18. Sanchez-Ortis RF, Tannir N et al. (2003) Spontaneous regression of pulmonary metastases from renal cell carcinoma after radiofrequency ablation of the primary tumor: an in situ tumor vaccine? J Urol 170:178–179

    PubMed  Google Scholar 

  19. Suzuki K, Moriyama N et al. (1998) Preliminary study of percutaneous alcohol injection into the lung. Jpn J Cancer Res 89:89–95

    CAS  PubMed  Google Scholar 

Download references

Interessenkonflikt:

Keine Angaben

Author information

Authors and Affiliations

  1. Institut für Diagnostische Radiologie und Neuroradiologie, Klinikum der Ernst-Moritz-Arndt-Universität Greifswald

    C. Weigel, M. Kirsch, B. Mensel, U. Nerger & N. Hosten

  2. Abteilung für Diagnostische und Interventionelle Radiologie, Ernst-Moritz-Arndt-Universität, Fr.-Loeffler-Str. 23a, 17489 , Greifswald

    C. Weigel

Authors
  1. C. Weigel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Kirsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. Mensel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. U. Nerger
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. N. Hosten
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Weigel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Weigel, C., Kirsch, M., Mensel, B. et al. Perkutane laserinduzierte Thermotherapie von Lungenmetastasen: Erfahrungen nach 4-jähriger Anwendung. Radiologe 44, 700–707 (2004). https://doi.org/10.1007/s00117-004-1083-z

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00117-004-1083-z

Schlüsselwörter

Keywords

Search

Navigation