Mauri Giovanni, Cova Luca, Monaco Cristian Giuseppe, Sconfienza Luca Maria, Corbetta Sabrina, Benedini Stefano, Ambrogi Federico, Milani Valentina, Baroli Alberto, Ierace Tiziana, Solbiati Luigi
a Division of Interventional Oncology , European Institute of Oncology , Milan , Italy.
b Radiology Service, IRCCS Policlinico San Donato , Milan , Italy.
Int J Hyperthermia. 2017 May;33(3):295-299. doi: 10.1080/02656736.2016.1244707. Epub 2016 Nov 15.
To evaluate the reduction over time of benign thyroid nodules treated using percutaneous laser ablation (PLA) and radiofrequency ablation (RFA) by the same equipe.
Ninety patients (age 55.6 ± 14.1 years) underwent ablation for benign thyroid nodule causing compression/aesthetic dissatisfaction from 2011. Fifty-nine (age 55.8 ± 14.1 years) underwent RFA and 31 (age 55.2 ± 14.2 years) PLA, ultrasound guided. Technical success, complications, duration of ablation and treatment, energy deployed, volumetric percentage reduction at 1, 6 and 12 months were derived. A regression model for longitudinal measurements was used with random intercept and random slope. Values are expressed as mean ± standard deviation or N (%).
Technical success was always obtained. No major complications occurred. Mean ablation time was 30.1 ± 13.8 vs. 13.9 ± 5.9 min (p < .0001) and mean energy deployment was 5422.3 ± 2484.5 J vs. 34 662.7 ± 15 812.3 J in PLA vs. RFA group. Mean volume reduced from 20.3 ± 16.4 ml to 13.17 ± 10.74 ml (42% ± 17% reduction) at 1st month, 8.7 ± 7.4 ml (60% ± 15% reduction) at 6th month and 7.1 ± 7.7 ml (70%% ± 16% reduction) at 12th month, in PLA group, and from 32.7 ± 19.5 ml to 17.2 ± 12.9 ml (51%±15% reduction) at 1st month, 12.8 ± 9.6 ml (64 ± 14% reduction) at 6th month and 9.9 ± 9.2 ml (74% ± 14% reduction) at 12th month in RFA group. No difference in time course of the relative volume reduction between the two techniques was found.
RFA and PLA are similarly feasible, safe and effective in treating benign thyroid nodules when performed by the same equipe. RFA is faster than PLA but require significantly higher energy.
评估同一团队使用经皮激光消融（PLA）和射频消融（RFA）治疗良性甲状腺结节随时间的缩小情况。
自2011年起，90例（年龄55.6±14.1岁）因良性甲状腺结节导致压迫/美容不满意的患者接受了消融治疗。59例（年龄55.8±14.1岁）接受了RFA，31例（年龄55.2±14.2岁）接受了超声引导下的PLA。得出技术成功率、并发症、消融及治疗持续时间、能量使用量、1个月、6个月和12个月时的体积缩小百分比。使用具有随机截距和随机斜率的纵向测量回归模型。数值以均值±标准差或N（%）表示。
总能获得技术成功。未发生重大并发症。PLA组与RFA组的平均消融时间分别为30.1±13.8分钟和13.9±5.9分钟（p<0.0001），平均能量使用量分别为5422.3±2484.5焦耳和34662.7±15812.3焦耳。PLA组在第1个月时平均体积从20.3±16.4毫升降至13.17±10.74毫升（缩小42%±17%），第6个月时降至8.7±7.4毫升（缩小60%±15%），第12个月时降至7.1±7.7毫升（缩小70%±16%）；RFA组在第1个月时平均体积从32.7± 19.5毫升降至17.2±12.9毫升（缩小51%±15%），第6个月时降至12.8±9.6毫升（缩小64%±14%），第12个月时降至9.9±9.2毫升（缩小74%±14%）。未发现两种技术在相对体积缩小时间进程上的差异。
当由同一团队进行操作时，RFA和PLA在治疗良性甲状腺结节方面同样可行、安全且有效。RFA比PLA速度更快，但需要显著更高的能量。
