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计算机断层扫描引导下氩氦刀冷冻消融术治疗骶骨脊索瘤

Computed tomography-guided argon-helium cryoablation for sacrum chordoma.

作者信息

Li Liang, Jiang Xiao-Fan, Sun Li-Jun, Fu Yu-Fei, Zhang Wei

机构信息

Department of Neurosurgery.

Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shanxi.

出版信息

Medicine (Baltimore). 2020 Oct 16;99(42):e22604. doi: 10.1097/MD.0000000000022604.

Abstract

We examined the therapeutic effects of argon-helium cryoablation guided by computed tomography (CT) in the treatment of sacral chordoma.This is a retrospective study. CT-guided argon-helium cryoablation was used to treat 9 sacral chordoma patients at our centers between January 2016 and June 2019. We collected data on treatment response and success. Data from long-term follow-up of treatment outcomes were also assessed.All patients were treated successfully according to the indicated technical parameters. There were no reports of procedure-related complications from any of the patients. Complete response (CR) was also achieved in all patients. Six patients (66.7%) achieved initial CR after 1 treatment session and 3 patients (33.3%) achieved secondary CR after 2 treatment sessions. The chordoma-related symptoms improved significantly in all patients after treatment. The mean visual analogue scale score improved from 7.3 before treatment to 4.2 after treatment (P < .001). The mean function score improved from 3.2 before treatment to 1.4 after treatment (P < .001). The median length of follow-up for all patients was 33 months (range: 6-46 months). All patients were alive during the follow-up. Two (22.2%) patients experienced local recurrence (LR) at 6 and 9 months after treatment, respectively. These patients had revised treatment with trans-arterial embolism (n = 1) or repeat ablation (n = 1). The median progression-free survival was 36.8 months.Treatment of sacral chordoma with CT-guided argon-helium cryoablation is effective and offers a potentially beneficial therapeutic alternative for patients with the condition.

摘要

我们研究了计算机断层扫描(CT)引导下的氩氦冷冻消融术治疗骶骨脊索瘤的疗效。这是一项回顾性研究。2016年1月至2019年6月期间,我们中心使用CT引导下的氩氦冷冻消融术治疗了9例骶骨脊索瘤患者。我们收集了治疗反应和成功率的数据。还评估了治疗结果的长期随访数据。所有患者均按照指定的技术参数成功接受治疗。所有患者均未报告与手术相关的并发症。所有患者均实现了完全缓解(CR)。6例患者(66.7%)在1次治疗后实现了初始CR,3例患者(33.3%)在2次治疗后实现了继发CR。治疗后所有患者的脊索瘤相关症状均有显著改善。视觉模拟量表平均评分从治疗前的7.3分提高到治疗后的4.2分(P<0.001)。功能平均评分从治疗前的3.2分提高到治疗后的1.4分(P<0.001)。所有患者的中位随访时间为33个月(范围:6 - 46个月)。随访期间所有患者均存活。2例患者(22.2%)分别在治疗后6个月和9个月出现局部复发(LR)。这些患者接受了经动脉栓塞(n = 1)或重复消融(n = 1)的修正治疗。中位无进展生存期为36.8个月。CT引导下的氩氦冷冻消融术治疗骶骨脊索瘤是有效的,为患有该疾病的患者提供了一种潜在有益的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b466/7572023/723ea9f205eb/medi-99-e22604-g002.jpg

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