Iguchi Toshihiro, Hiraki Takao, Gobara Hideo, Fujiwara Hiroyasu, Matsui Yusuke, Toyooka Shinichi, Nishizaki Kazunori, Kanazawa Susumu
Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho kita-ku, Okayama 700-8558, Japan.
Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho kita-ku, Okayama 700-8558, Japan.
J Vasc Interv Radiol. 2015 May;26(5):703-8. doi: 10.1016/j.jvir.2014.11.040. Epub 2015 Feb 2.
To retrospectively evaluate the outcomes of radiofrequency (RF) ablation of lung metastases from head and neck adenoid cystic carcinoma (ACC).
Nine patients (two men and seven women; mean age, 61.6 y) with 45 lung metastases (mean diameter, 1.1 cm; range, 0.4-2.7 cm) from head and neck ACC underwent RF ablation in 30 sessions. Primary endpoints were technical success, technique effectiveness, and procedural complications. Secondary endpoints included overall survival (OS).
RF ablation was technically successful for all 45 metastases. The median tumor follow-up period was 37.1 months (range, 12.9-128.3 mo). Local progression occurred in six tumors, two of which were treated again and subsequently showed complete response. Major complications (pneumothorax requiring chest tube placement) occurred in five sessions (16.7%). The median patient follow-up period was 61.6 months (range, 20.5-134.5 mo). Two patients died of disease progression at 38.9 and 61.6 months after RF ablation, respectively, whereas the other seven remained alive at the end of the study. OS rates from the initial RF ablation were 100% at 3 years and 83.3% at 5 years (mean survival time, 106.4 mo). OS rates from the treatment of the primary site were 100% at 5 years and 62.5% at 10 years (mean survival time, 210.1 mo).
Radiofrequency ablation is an acceptable and effective local treatment for lung metastases from head and neck ACC. However, further study is needed to evaluate its effect on patient survival.
回顾性评估射频(RF)消融治疗头颈部腺样囊性癌(ACC)肺转移瘤的疗效。
9例(2例男性,7例女性;平均年龄61.6岁)头颈部ACC肺转移瘤患者共45个转移灶(平均直径1.1 cm;范围0.4 - 2.7 cm)接受了30次射频消融治疗。主要终点为技术成功率、技术有效性和手术并发症。次要终点包括总生存期(OS)。
45个转移灶的射频消融技术均成功。肿瘤中位随访期为37.1个月(范围12.9 - 128.3个月)。6个肿瘤出现局部进展,其中2个再次接受治疗并随后显示完全缓解。主要并发症(需要放置胸管的气胸)发生在5次治疗中(16.7%)。患者中位随访期为61.6个月(范围20.5 - 134.5个月)。2例患者分别在射频消融后38.9个月和61.6个月死于疾病进展,而其他7例在研究结束时仍存活。首次射频消融后的3年总生存率为100%,5年为83.3%(平均生存时间106.4个月)。原发部位治疗后的5年总生存率为100%,10年为62.5%(平均生存时间210.1个月)。
射频消融是治疗头颈部ACC肺转移瘤的一种可接受且有效的局部治疗方法。然而,需要进一步研究评估其对患者生存的影响。