Objective: To explore the feasibility and efficiency of CT-guided percutaneous ethanol ablation (PEA) in the treatment of malignant tumors with pleural or chest wall invasion.
Methods: Nine patients of malignant tumors with pleural or chest wall invasion that failed to respond to operation, radiotherapy, or chemotherapy were treated by PEA under CT guidance. The improvement of quality of life (QOL) during the treatment was observed and the efficiency was evaluated by CT scan. Follow-up was conducted for 6 - 24 months.
Results: After successful ethanol ablation, cancer pain of the patients was relieved obviously and pain degree reduced to 0 - 3 score according to the numerical rating scale (NRS). Cough and hemoptysis disappeared. Appetite and sleeping were improved markedly. Body weight increased and the Karnofsky performance status (KPS) score was over 90. No serious adverse effect and complication occurred during and after PEA. PEA was performed successfully 34 times in 18 lesions of these 9 patients. In follow-up, local recurrence and new tumors appeared in 2 patients, but good results were achieved after the second PEA treatment. One tumor came to recurrence in a patient of lung cancer, but it was well controlled after another two times of PEA treatment. One patient with lung cancer gave up treatment and came to recurrence after successful PEA treatment 7 months later. Two patients of primarily hepatocellular carcinoma died of brain metastases 8 and the 9 months after treatment.
Conclusion: With little damage and few complications, CT-guided PEA is convenient and effective in treatment of malignant tumors with pleural invasion.