Yue Wenwen, Chen Liang, Wang Shurong, Yu Shoujun
Department of Ultrasound, Yantai Affiliated Hospital, Binzhou Medical University , Yantai, Shandong , China and.
Int J Hyperthermia. 2015 Jun;31(4):403-8. doi: 10.3109/02656736.2015.1014433. Epub 2015 Mar 20.
The aim of this study was to evaluate the safety and efficiency of ultrasound-guided percutaneous microwave (MW) ablation for the control of locally recurrent papillary thyroid carcinoma (LR-PTC) in patients for whom surgery is not viable.
The inclusion criteria for MW ablation were three or fewer LR-PTCs and no recurrence beyond the neck, with ineligibility or refusal to undergo surgery. MW ablation was carried out using a 16-gauge MW antenna under local anaesthesia. Patients were then followed at 1, 3, 6 and 12 months after treatment and every 6 months thereafter. Technical success usually meant volume reduction more than 50%.
Between October 2010 to March 2013 a total of 17 patients (14 women, 3 men; average age 54.1 years) with 23 LR-PTCs, were treated with MW ablation in our department. All the LR-PTCs were technical successes with the number of treatment sessions for one tumour ranging from 1 to 4 (mean, 2.3 ± 0.9). The mean volume reduction ratio of the LR-PTCs was 1 ± 86%, 47 ± 12%, 70 ± 33%, 91 ± 14% at the 1, 3, 6 and 18 months follow-up visit respectively (all p < 0.05). All treated nodules decreased in size: 30.4% nodules (7/23) had completely disappeared, 52.2% nodules (12/23) remained as small scar-like lesions. One patient experienced transient dysphonia immediately after MW ablation. No other severe and permanent complications occurred.
Although with some limitations, our preliminary results are encouraging and show MW ablation may be an alternative treatment option for the control of LR-PTCs in selected patients for whom surgery is not viable.
本研究旨在评估超声引导下经皮微波消融术对无法进行手术的局部复发性乳头状甲状腺癌（LR-PTC）患者的安全性和有效性。
微波消融的纳入标准为LR-PTC不超过3个且无颈部以外复发，不符合手术条件或拒绝接受手术。在局部麻醉下使用16G微波天线进行微波消融。治疗后1、3、6和12个月以及之后每6个月对患者进行随访。技术成功通常意味着体积缩小超过50%。
2010年10月至2013年3月，我科共对17例患者（14例女性，3例男性；平均年龄54.1岁）的23个LR-PTC进行了微波消融治疗。所有LR-PTC均取得技术成功，单个肿瘤的治疗次数为1至4次（平均2.3±0.9次）。在1、3、6和18个月随访时，LR-PTC的平均体积缩小率分别为1±86%、47±12%、70±33%、91±14%（均P<0.05）。所有治疗的结节均缩小：30.4%的结节（7/23）完全消失，52.2%的结节（12/23）残留为小的瘢痕样病变。1例患者在微波消融后立即出现短暂性发音困难。未发生其他严重和永久性并发症。
尽管存在一些局限性，但我们的初步结果令人鼓舞，表明微波消融可能是无法进行手术的特定LR-PTC患者的一种替代治疗选择。
