Department of Ultrasound, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, 197 Ruijin 2 Rd, Shanghai, 200025, China.
Lasers Surg Med. 2020 Nov;52(9):855-862. doi: 10.1002/lsm.23238. Epub 2020 Mar 26.
The objective of this study is to compare the efficacy and the safety of ultrasound-guided microwave ablation (MWA) and laser ablation (LA) for the treatment of papillary thyroid microcarcinoma (PTMC).
STUDY DESIGN/MATERIALS AND METHODS: A total of 67 patients with unifocal PTMC were studied retrospectively, including 33 cases who underwent MWA (MWA group) and 34 cases who received LA (LA group). The follow-up consisted of thyroid function tests, ultrasonography, contrast-enhanced ultrasonography (CEUS), and chest X-ray or computed tomography scan. The treatment response and complications were compared between the two groups.
The follow-up time for the MWA and LA group was 23.3 ± 4.4 and 22.8 ± 4.1 months, respectively. All the ablations were successfully performed as planned without complementary ablations, and it was confirmed by CEUS after treatment in both groups. It was observed that, at the last follow-up, the mean largest diameter decreased from 5.0 ± 1.4 mm to 0.1 ± 0.4 mm (MWA group) and from 4.5 ± 1.6 mm to 0.6 ± 1.2 mm(LA group) (P < 0.05 for both). The average volume reduced from 51.9 ± 40.8 to 0.2 ± 1.0 mm (MWA group) and from 38.5 ± 43.0 to 1.3 ± 3.8 mm (LA group) (P < 0.05 for both). The complication rates did not differ between the MWA group (9.1%) and the LA group (2.9%) (P > 0.05). No local recurrence or distant metastasis occurred in either group.
During the short-term follow-up period, ultrasound-guided MWA and LA were both safe and effective methods in treating patients with unifocal PTMC. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.
本研究旨在比较超声引导下微波消融(MWA)和激光消融(LA)治疗甲状腺微小乳头状癌(PTMC)的疗效和安全性。
研究设计/材料和方法:回顾性分析了 67 例单灶性 PTMC 患者的临床资料,其中 33 例行 MWA(MWA 组),34 例行 LA(LA 组)。随访包括甲状腺功能检查、超声、超声造影(CEUS)、胸部 X 线或 CT 扫描。比较两组患者的治疗反应和并发症。
MWA 组和 LA 组的随访时间分别为 23.3±4.4 个月和 22.8±4.1 个月。两组均成功按计划完成消融治疗,且治疗后均经 CEUS 证实。末次随访时,MWA 组最大直径由治疗前的 5.0±1.4mm 缩小至 0.1±0.4mm(P<0.05),体积由 51.9±40.8mm 缩小至 0.2±1.0mm(P<0.05);LA 组最大直径由治疗前的 4.5±1.6mm 缩小至 0.6±1.2mm(P<0.05),体积由 38.5±43.0mm 缩小至 1.3±3.8mm(P<0.05)。MWA 组并发症发生率为 9.1%(3/33),LA 组为 2.9%(1/34),两组差异无统计学意义(P>0.05)。两组均无局部复发或远处转移。
在短期随访中,超声引导下 MWA 和 LA 治疗单灶性 PTMC 均安全有效。