a Department of Diagnostic Imaging , "Regina Apostolorum" Hospital , Albano Laziale , Italy.
b Department of Interventional Radiology , European Institute of Oncology , Milan , Italy.
Int J Hyperthermia. 2017 Dec;33(8):911-919. doi: 10.1080/02656736.2017.1332395. Epub 2017 Jun 12.
To compare technique efficacy and safety of laser ablation (LA) and radiofrequency ablation (RFA) in treatment of benign thyroid nodules.
Institutional review board approval was obtained, and patients' consent was waived. 601 nodules were treated from May 2009 to December 2014 at eight centres, 449 (309 females, age 57 ± 14 years) with LA and 152 (107 females, age 57 ± 14 years) with RFA. A matched cohort composed of 138 patients from each group was selected after adjustment with propensity score matching. Factors influencing volume reduction at 6 and 12 months and complications were evaluated.
No significant differences were observed in the baseline characteristics between groups after propensity score matching adjustment. Mean nodule reduction at 6 and 12 months was -67 ± 19% vs. -57 ± 21% (p < 0.001) - 70 ± 19% vs. -62 ± 22% (p = 0.001) in LA group and in RFA group, respectively. Nodules with volume >30 mL had significantly higher percentage volume reduction at 6 and 12 months (-69 ± 19 vs. -50 ± 21, p = 0.001) and (-73 ± 18 vs. -54 ± 23 8, p = 0.001) in the LA group than in the RFA group, respectively. In both groups, operator's skills affected the results. Major complications occurred in 4 cases in each group (p = 0.116) Conclusions: LA and RFA showed nearly similar outcome but LA was slightly more effective than RFA in large nodules. Operator's skills could be crucial in determining the extent of nodule volume reduction regardless of the used technique.
比较激光消融（LA）和射频消融（RFA）治疗良性甲状腺结节的技术效果和安全性。
本研究获得了机构审查委员会的批准，并豁免了患者的同意。2009 年 5 月至 2014 年 12 月，8 个中心共治疗了 601 个结节，其中 449 个（309 名女性，年龄 57±14 岁）接受了 LA 治疗，152 个（107 名女性，年龄 57±14 岁）接受了 RFA 治疗。在进行倾向评分匹配调整后，从每组中选择了 138 名匹配患者组成匹配队列。评估了影响 6 个月和 12 个月体积减少的因素以及并发症。
在进行倾向评分匹配调整后，两组患者的基线特征无显著差异。LA 组和 RFA 组的结节体积在 6 个月和 12 个月时的平均减少率分别为-67±19%和-57±21%（p<0.001）和-70±19%和-62±22%（p=0.001）。体积>30mL 的结节在 6 个月和 12 个月时的体积减少百分比明显更高（LA 组为-69±19%比-50±21%，p=0.001；RFA 组为-73±18%比-54±23%，p=0.001）。在两组中，操作者的技术水平均会影响结果。每组均有 4 例发生主要并发症（p=0.116）。结论：LA 和 RFA 的结果几乎相似，但 LA 在大结节中的效果略优于 RFA。无论使用何种技术，操作者的技术水平都可能是决定结节体积减少程度的关键因素。
