de Nucci Germana, Imperatore Nicola, Mandelli Enzo Domenico, di Nuovo Franca, d'Urbano Corrado, Manes Gianpiero
Gastroenterology and Endoscopy Unit, ASST Rhodense, Garbagnate Milanese, Milan, Italy.
Gastroenterology, Department of Clinical Medicine and Surgery, School of Medicine Federico II of Naples, Naples, Italy.
Endosc Int Open. 2020 Dec;8(12):E1754-E1758. doi: 10.1055/a-1261-9359. Epub 2020 Nov 17.
Surgery is the considered the therapeutic cornerstone for pancreatic neuroendocrine tumors (P-NETs), although burdened by high risk of significant adverse events. Recently, endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) has been described for P-NETs. We aimed to evaluate the effectiveness and safety of EUS-RFA for treatment of P-NETs. We prospectively included all consecutive patients with P-NET ≤ 20 mm who were treated with EUS-RFA and were followed-up for at least 12 months. Ten patients (5 males, mean age 78.6 years, mean body mass index 28.2) with 11 P-NETs (mean size 14.5 mm; range 9 - 20 mm) localized in the pancreatic head (3 lesions), pancreatic body (5 lesions), and tail (3 lesions) underwent complete EUS ablation with one session of RFA. Complete ablation of P-NET was reached using a single-session RFA with a mean of 2.3 treatment applications per session. At both 6 - and 12-months computed tomography scans, all the patients had complete disappearance of lesions with radiological normalization. Regarding safety, only two cases of mild abdominal pain were recorded in two subjects with pancreatic head lesion, which were effectively treated with analgesics. The mean duration of hospital stay was 4 days (range 3 - 7 days). EUS-RFA is effective and safe in treating P-NETs. It may be considered an effective therapeutic option in the treatment of small P-NETs independently from their functional status.
手术被认为是胰腺神经内分泌肿瘤（P-NETs）的治疗基石，尽管存在严重不良事件的高风险。最近，内镜超声引导下射频消融术（EUS-RFA）已被用于P-NETs的治疗。我们旨在评估EUS-RFA治疗P-NETs的有效性和安全性。我们前瞻性纳入了所有连续的P-NET直径≤20mm且接受EUS-RFA治疗并随访至少12个月的患者。10例患者（5例男性，平均年龄78.6岁，平均体重指数28.2），共11个P-NETs（平均大小14.5mm；范围9-20mm），位于胰头（3个病灶）、胰体（5个病灶）和胰尾（3个病灶），接受了单次RFA的完整EUS消融。通过单次RFA实现了P-NET的完全消融，每次治疗平均应用2.3次。在6个月和12个月的计算机断层扫描中，所有患者的病灶均完全消失，影像学表现正常。在安全性方面，仅2例胰头病变患者记录有轻度腹痛，经镇痛药有效治疗。平均住院时间为4天（范围3-7天）。EUS-RFA治疗P-NETs有效且安全。无论其功能状态如何，它都可被视为治疗小P-NETs的有效治疗选择。
