Dipartimento di Oncologia, Istituto di Radiologia, Università di Torino, Regione Gonzole 10, Orbassano, TO, Italy,
Radiol Med. 2014 May;119(5):327-33. doi: 10.1007/s11547-013-0354-z. Epub 2013 Dec 3.
The study was done to analyse the results of a series of radiofrequency ablation (RFA) procedures performed on hepatic metastases (METS) from breast cancer in order to evaluate the clinical impact of this therapy.
We analysed 45 patients (mean age 55 years) with 87 METS (mean size 23 mm), in terms of adverse events (AE), complete ablation (CA) at initial follow-up assessment and during the subsequent follow-up (mean 30 months), time to progression, and survival. The correlation between local effectiveness and METS size was investigated. Possible predictors of 3-year survival, including the local effectiveness of RFA (complete ablation maintained at 1-year versus treatment failure) were analysed.
Nine AE occurred (two major complications, 2.3 %). CA at initial follow-up was obtained in 90 %; 19.7 % CA relapsed, with a time to progression of 8 months. The difference between the mean diameter of maintained CA (22 mm) and that of the treatment failures (30 mm) was highly significant (p = 0.0005), as was the 30 mm threshold (p = 0.0062). Overall survival at 1-3 years was 90, 58 and 44 %. At univariate analysis, the local effectiveness of RFA did not reach statistical significance.
RFA of hepatic METS from breast cancer has high local effectiveness in tumours up to 30 mm, but it is not relevant in determining survival.
本研究旨在分析一系列针对乳腺癌肝转移灶(METS)行射频消融(RFA)治疗的结果,以评估该治疗的临床影响。
我们分析了 45 名(平均年龄 55 岁)患者的 87 个 METS(平均大小 23mm),评估了不良事件(AE)、初始随访评估时的完全消融(CA)以及随后的随访(平均 30 个月)、进展时间和生存情况。研究了局部疗效与 METS 大小之间的关系。分析了 RFA 局部疗效(1 年时保持完全消融与治疗失败)与 3 年生存率之间的可能相关性。
发生了 9 例 AE(2 例严重并发症,2.3%)。90%的患者在初始随访时获得 CA;19.7%的患者出现 CA 复发,进展时间为 8 个月。保持 CA(22mm)的平均直径与治疗失败(30mm)的直径差异具有统计学意义(p=0.0005),30mm 阈值也具有统计学意义(p=0.0062)。1-3 年总生存率分别为 90%、58%和 44%。单因素分析显示,RFA 的局部疗效未达到统计学意义。
对于直径不超过 30mm 的乳腺癌肝 METS,RFA 具有较高的局部疗效,但对生存无显著影响。