Introduction of microwave ablation for lung cancer With the rapid development of imaging technology, percutaneous image-guided local ablation as a minimally invasive treatment for tumor has developed rapidly in recent years at home and abroad, and has gradually become one of the common means of non-surgical treatment for tumor. I. What is the principle of image guided microwave ablation for lung cancer treatment? Under the guidance of CT and other imaging technologies, a special treatment needle (microwave antenna or microwave “tip”) is used to enter the lung tumor through skin puncture for treatment. The principle of microwave ablation is actually the same as the principle of microwave oven, through the thermal effect of microwave, the local tumor tissue in the lung reaches a temperature of over 70℃ within a few minutes, causing coagulative necrosis of the tumor tissue with little or no damage to the surrounding tissues. The purpose is to “burn” the tumor cells. Which lung cancer patients are suitable for microwave ablation treatment? (A) Indications for local radical treatment 1.Primary peripheral lung cancer: Patients cannot tolerate surgery or cannot be surgically resected or do not receive surgery or other local treatment after recurrence (such as moderate radiotherapy), and the maximum tumor diameter ≤ 3.5cm. 2.Metastatic peripheral lung cancer: The number of lesions in one lung ≤ 3, and the maximum tumor diameter ≤ 3.5cm. (B) Indications for palliative tumor load reduction or symptom relief The purpose of treatment is to minimize the tumor load and alleviate the symptoms caused by the tumor. Contraindications of microwave ablation for lung cancer treatment 1.The lesion is ≤1cm away from the lung door, the treatment target skin distance is <2cm, and there is no effective puncture channel. 2. Infectious and radiological inflammation around the lesion is not well controlled. Ablation of malignant pleural effusion ipsilateral to the lesion is not well controlled. 3.Patients with severe bleeding tendency, platelets less than 50×109/L and serious disorders of coagulation system (prothrombin time >18S, prothrombin activity <40%). 4.Patients with severe hepatic, renal, cardiac, pulmonary and cerebral insufficiency, severe anemia, dehydration and serious disorders of nutrient metabolism that cannot be corrected or improved within a short period of time, severe systemic infections and high fever (>38.5℃). 5. Advanced tumor patients with KPS score 70 and psychiatric patients are not suitable for microwave ablation treatment. 4.What are the complications of microwave ablation for lung cancer? Pneumothorax is the most common complication, with an incidence rate of about 20%, but only 5% of them need to be treated. Others, such as infection and bleeding, have a lower incidence. The incidence of thermal injury to adjacent organs and burns at the puncture site is extremely low. V. What are the advantages of microwave ablation for lung cancer treatment? 1. Minimally invasive. Only a “needle” (2mm in diameter) is used to precisely enter the tumor under CT guidance, and there is only a needle eye of less than 3mm in the skin, so there is no scar and no suture. 2.Short treatment time and high efficacy. Tumors with single lesion ≤5 cm can be inactivated at one time, and one treatment time only takes about 15 minutes. The treatment time is only about 15 minutes. There are few complications and the body recovers quickly, requiring only 3-5 days of hospitalization. 3. Conformal ablation can be performed, which is based on the shape of the tumor, which can improve the therapeutic effect and reduce recurrence. 4.Wide indications, for patients who cannot be removed surgically, still can be treated, especially for elderly patients and patients with poor lung function. It can achieve the effect of tumor reduction, palliative treatment, alleviate pain, prolong life and improve quality of life. In addition, it can be repeatedly treated several times. 5.It can be widely combined with other treatments, such as combined with molecular targeting drugs, etc. 6.The cost is low, only one-half of the cost of surgery. Example 1 Patient, male, 82 years old, peripheral lung cancer of the left lung. Example 2 Patient, male, 58 years old. Peripheral lung cancer of the left lung. The patient refused surgical treatment and had 4 cycles of chemotherapy followed by 6800 cGy of conformal radiotherapy, which once remitted, but the tumor recurred after 3 months.