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骨转移性乳腺癌患者的乳腺冷冻消融术。

Breast cryoablation in patients with bone metastatic breast cancer.

作者信息

Pusceddu Claudio, Sotgia Barbara, Amucano Giovanni, Fele Rosa Maria, Pilleri Sara, Meloni Giovanni Battista, Melis Luca

机构信息

Division of Interventional Radiology, Ocological Hospital "A. Businco," Regional Referral Center for Oncologic Diseases, Cagliari 09100, Italy.

Department of Oncological Radiology, Ocological Hospital "A. Businco," Regional Referral Center for Oncologic Diseases, Cagliari 09100, Italy.

出版信息

J Vasc Interv Radiol. 2014 Aug;25(8):1225-32. doi: 10.1016/j.jvir.2014.05.001. Epub 2014 Jun 16.

Abstract

PURPOSE

To assess retrospectively the safety and feasibility of palliative breast cryoablation to treat primary breast tumors in patients with stage IV breast cancer.

MATERIALS AND METHODS

In 17 female patients (mean age ± SD, 59 y ± 13; range, 37-81 y) with 22 bone metastatic ductal invasive breast lesions (2.5 cm × 1.6 cm ± 1.4 × 1.1; range, 1.0 cm × 0.5 cm to 6.7 cm × 5.5 cm), 19 computed tomography (CT)-guided percutaneous cryoablation sessions were performed for treatment of primary breast tumors. All patients had radiologic evidence (contrast-enhanced CT or magnetic resonance imaging) of persistence or progression of the primary breast cancer despite systemic therapy. The radiologic outcome was evaluated with a mean follow-up period of 13 months (range, 3-31 mo). Treatment of skeletal metastases was unnecessary during the follow-up period.

RESULTS

All of the cryoablation sessions were completed and well tolerated. Complete regression of the disease was achieved in 15 (88%) patients 2 months after the cryoablation. Two (12%) patients underwent a second cryoablation treatment because of a minimal persistence of viable tumor (residual disease). No relapse of primary tumors was observed on breast imaging during the follow-up period. One patient (6%) developed a new lesion localized to the contralateral breast.

CONCLUSIONS

These data suggest that palliative cryoablation of primary advanced breast cancer is a well-tolerated, feasible, and effective treatment option. Given the palliative effects of breast cryoablation demonstrated in this series, larger studies replicating these results are warranted.

摘要

目的

回顾性评估姑息性乳腺冷冻消融术治疗IV期乳腺癌患者原发性乳腺肿瘤的安全性和可行性。

材料与方法

17例女性患者(平均年龄±标准差,59岁±13岁;范围,37 - 81岁),有22处骨转移性导管浸润性乳腺病变(2.5 cm×1.6 cm±1.4×1.1;范围,1.0 cm×0.5 cm至6.7 cm×5.5 cm),对原发性乳腺肿瘤进行了19次计算机断层扫描(CT)引导下的经皮冷冻消融治疗。所有患者尽管接受了全身治疗,但仍有原发性乳腺癌持续存在或进展的影像学证据(增强CT或磁共振成像)。平均随访13个月(范围,3 - 31个月)评估影像学结果。随访期间无需治疗骨转移。

结果

所有冷冻消融治疗均完成且耐受性良好。冷冻消融术后2个月,15例(88%)患者疾病完全消退。2例(12%)患者因仍有少量存活肿瘤(残留病灶)而接受了第二次冷冻消融治疗。随访期间乳腺影像学检查未观察到原发性肿瘤复发。1例患者(6%)对侧乳腺出现新病灶。

结论

这些数据表明,原发性晚期乳腺癌的姑息性冷冻消融是一种耐受性良好、可行且有效的治疗选择。鉴于本系列研究显示的乳腺冷冻消融的姑息效果,有必要开展更大规模的研究来重复这些结果。

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