Ghanouni Pejman, Dobrotwir Andrew, Bazzocchi Alberto, Bucknor Matthew, Bitton Rachelle, Rosenberg Jarrett, Telischak Kristen, Busacca Maurizio, Ferrari Stefano, Albisinni Ugo, Walters Shannon, Gold Garry, Ganjoo Kristen, Napoli Alessandro, Pauly Kim Butts, Avedian Raffi
Department of Radiology, Stanford University School of Medicine, Stanford, California.
Department of Radiology, The Royal Women's Hospital, Parkville, Victoria, Australia.
Eur Radiol. 2017 Feb;27(2):732-740. doi: 10.1007/s00330-016-4376-5. Epub 2016 May 5.
To assess the feasibility, safety and preliminary efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) for the treatment of extra-abdominal desmoid tumours.
Fifteen patients with desmoid fibromatosis (six males, nine females; age range, 7-66 years) were treated with MRgFUS, with seven patients requiring multiple treatments (25 total treatments). Changes in viable and total tumour volumes were measured after treatment. Efficacy was evaluated using an exact one-sided Wilcoxon test to determine if the median reduction in viable tumour measured immediately after initial treatment exceeded a threshold of 50 % of the targeted volume. Median decrease after treatment of at least two points in numerical rating scale (NRS) worst and average pain scores was tested with an exact one-sided Wilcoxon test. Adverse events were recorded.
After initial MRgFUS treatment, median viable targeted tumour volume decreased 63 %, significantly beyond our efficacy threshold (P = 0.0013). Median viable total tumour volume decreased (105 mL [interquartile range {IQR}, 217 mL] to 54 mL [IQR, 92 mL]) and pain improved (worst scores, 7.5 ± 1.9 vs 2.7 ± 2.6, P = 0.027; average scores, 6 ± 2.3 vs 1.3 ± 2, P = 0.021). Skin burn was the most common complication.
MRgFUS significantly and durably reduced viable tumour volume and pain in this series of 15 patients with extra-abdominal desmoid fibromatosis.
• Retrospective four-centre study shows MRgFUS safely and effectively treats extra-abdominal desmoid tumours • This non-invasive procedure can eradicate viable tumour in some cases • Alternatively, MRgFUS can provide durable control of tumour growth through repeated treatments • Compared to surgery or radiation, MRgFUS has relatively mild side effects.
评估磁共振引导聚焦超声（MRgFUS）治疗腹外硬纤维瘤的可行性、安全性及初步疗效。
15例硬纤维瘤病患者（6例男性，9例女性；年龄范围7 - 66岁）接受了MRgFUS治疗，7例患者需要多次治疗（共25次治疗）。治疗后测量存活肿瘤体积和总体积的变化。使用精确单侧Wilcoxon检验评估疗效，以确定初始治疗后立即测量的存活肿瘤体积中位数减少是否超过目标体积的50%阈值。使用精确单侧Wilcoxon检验测试数字评分量表（NRS）中最差和平均疼痛评分在治疗后至少下降两点的情况。记录不良事件。
首次MRgFUS治疗后，存活目标肿瘤体积中位数下降63%，显著超过我们的疗效阈值（P = 0.0013）。存活肿瘤总体积中位数下降（从105 mL[四分位数间距{IQR}，217 mL]降至54 mL[IQR，92 mL]），疼痛改善（最差评分，7.5±1.9对2.7±2.6，P = 0.027；平均评分，6±2.3对1.3±2，P = 0.021）。皮肤灼伤是最常见的并发症。
在这组15例腹外硬纤维瘤病患者中，MRgFUS显著且持久地减少了存活肿瘤体积并减轻了疼痛。
• 回顾性四中心研究表明MRgFUS安全有效地治疗腹外硬纤维瘤 • 这种非侵入性手术在某些情况下可根除存活肿瘤 • 或者，MRgFUS可通过重复治疗持久控制肿瘤生长 • 与手术或放疗相比，MRgFUS的副作用相对较轻。
