Kohlenberg Jacob, Welch Brian, Hamidi Oksana, Callstrom Matthew, Morris Jonathan, Sprung Juraj, Bancos Irina, Young William
Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Cancers (Basel). 2019 Feb 7;11(2):195. doi: 10.3390/cancers11020195.
Metastatic pheochromocytoma and paraganglioma (PPGL) are incurable neuroendocrine tumors. The goals of treatment include palliating symptoms and reducing tumor burden. Little is known about the use of radiofrequency ablation (RFA), cryoablation (CRYO), and percutaneous ethanol injection (PEI) to treat metastatic PPGL. We performed a retrospective study of patients age 17 years and older with metastatic PPGL who were treated with ablative therapy at Mayo Clinic, USA, between June 14, 1999 and November 14, 2017. Our outcomes measures were radiographic response, procedure-related complications, and symptomatic improvement. Thirty-one patients with metastatic PPGL had 123 lesions treated during 42 RFA, 23 CRYO, and 4 PEI procedures. The median duration of follow-up was 60 months (range, 0⁻163 months) for non-deceased patients. Radiographic local control was achieved in 69/80 (86%) lesions. Improvement in metastasis-related pain or symptoms of catecholamine excess was achieved in 12/13 (92%) procedures. Thirty-three (67%) procedures had no known complications. Clavien-Dindo Grade I, II, IV, and V complications occurred after 7 (14%), 7 (14%), 1 (2%), and 1 (2%) of the procedures, respectively. In patients with metastatic PPGL, ablative therapy can effectively achieve local control and palliate symptoms.
转移性嗜铬细胞瘤和副神经节瘤（PPGL）是无法治愈的神经内分泌肿瘤。治疗目标包括缓解症状和减轻肿瘤负荷。关于使用射频消融（RFA）、冷冻消融（CRYO）和经皮乙醇注射（PEI）治疗转移性PPGL的情况知之甚少。我们对1999年6月14日至2017年11月14日期间在美国梅奥诊所接受消融治疗的17岁及以上转移性PPGL患者进行了一项回顾性研究。我们的结局指标是影像学反应、与手术相关的并发症和症状改善情况。31例转移性PPGL患者的123个病灶在42次RFA、23次CRYO和4次PEI手术中得到治疗。非死亡患者的中位随访时间为60个月（范围0至163个月）。80个病灶中的69个（86%）实现了影像学局部控制。13次手术中的12次（92%）转移相关疼痛或儿茶酚胺过量症状得到改善。33次（67%）手术无已知并发症。Clavien-Dindo I级、II级、IV级和V级并发症分别发生在7次（14%）、7次（14%）、1次（2%）和1次（2%）手术之后。对于转移性PPGL患者，消融治疗可有效实现局部控制并缓解症状。
