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骨样骨瘤经皮冷冻消融的I期临床试验

Phase I clinical trial of percutaneous cryoablation for osteoid osteoma.

作者信息

Miyazaki Masaya, Saito Kenichi, Yanagawa Takashi, Chikuda Hirotaka, Tsushima Yoshito

机构信息

Department of Interventional Radiology and Clinical Ultrasound Center, Gunma University Hospital, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan.

Department of Orthopedic Surgery, Gunma University Hospital, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan.

出版信息

Jpn J Radiol. 2018 Nov;36(11):669-675. doi: 10.1007/s11604-018-0768-6. Epub 2018 Aug 14.

Abstract

PURPOSE

This prospective phase I trial was conducted to evaluate the safety of percutaneous cryoablation for osteoid osteoma (OO).

MATERIALS AND METHODS

Nine patients with OO (mean tumor size: 5.9 mm; tibia, n = 5; femur, n = 2; lumbar spine, n = 2) were enrolled and treated with percutaneous cryoablation. The primary endpoint was the evaluation of the treatment safety as determined using step-by-step registration. The secondary endpoints were the incidence and grade of adverse events by CTCAE version 4.0, and the short-term efficacy of this treatment. Based on a decrease in the numerical rating scale (NRS) score, efficacy was classified as significantly effective (SE ≥ 5 or reached 0-2), moderately effective (ME 2-4), or not effective (NE < 2 or increase).

RESULTS

Cryoablation procedures were completed in all patients. Major adverse events (≥ grade 3) related to the procedure were not observed. Minor adverse events (≤ grade2) were observed in 22-67%. The mean NRS score was 7 before treatment, 0.6 at 4-week, 0.1 at 6-month, and 0 at 1-year post-treatment. All procedures were classified as SE.

CONCLUSION

Percutaneous cryoablation is a safe treatment for OO. Future phase II trials with large patient cohorts are warranted.

摘要

目的

本前瞻性I期试验旨在评估经皮冷冻消融治疗骨样骨瘤(OO)的安全性。

材料与方法

纳入9例骨样骨瘤患者(平均肿瘤大小:5.9 mm;胫骨5例,股骨2例,腰椎2例),接受经皮冷冻消融治疗。主要终点是通过逐步登记确定治疗安全性的评估。次要终点是根据CTCAE 4.0版评估不良事件的发生率和分级,以及该治疗的短期疗效。根据数字评分量表(NRS)评分的降低情况,疗效分为显著有效(SE≥5或降至0 - 2)、中度有效(ME 2 - 4)或无效(NE < 2或升高)。

结果

所有患者均完成冷冻消融手术。未观察到与手术相关的严重不良事件(≥3级)。22% - 67%的患者观察到轻微不良事件(≤2级)。治疗前NRS平均评分为7分,治疗后4周为0.6分,6个月为0.1分,1年为0分。所有手术均分类为显著有效。

结论

经皮冷冻消融是治疗骨样骨瘤的一种安全治疗方法。未来有必要开展更大患者队列的II期试验。

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