Dipartimento di Oncologia ed Emato-Oncologia, Università degli Studi di Milano, Milan, Italy.
Divisione di Radiologia interventistica, Istituto Europeo di Oncologia, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy.
Front Endocrinol (Lausanne). 2021 Jan 8;11:575152. doi: 10.3389/fendo.2020.575152. eCollection 2020.
PURPOSE: To report the results of our preliminary experience in treating patients with papillary thyroid microcarcinoma (PTMC) with image-guided thermal ablation, in particular estimating the feasibility, safety and short-term efficacy. MATERIALS AND METHODS: From 2018 patients with cytologically proven PTMC < 10 mm were discussed in a multidisciplinary team and evaluated for feasibility of image-guided thermal ablation. In case of technical feasibility, the three possible alternatives (i.e., image-guided thermal ablation, surgery, and active surveillance) were discussed with patients. Patients who agreed to be treated with image guided thermal ablation underwent radiofrequency (RFA) or laser ablation under local anesthesia and conscious sedation. Treatment feasibility, technical success, technique efficacy, change in thyroid function tests, side effects, minor and major complications, patients satisfaction and pain/discomfort perception during and after treatment, and disease recurrence during follow-up were recorded. RESULTS: A total of 13 patients were evaluated, and 11/13 (84.6%) patients (9 female, 2 male, mean age 49.3 ± 8.7 years) resulted suitable for image-guided thermal ablation. All 11 patients agreed to be treated with image-guided thermal ablation. In addition, 3/11 (27.3%) were treated with laser ablation and 8/11 (72.7%) with RFA. All procedures were completed as preoperatively planned (technical success 100%). Technique efficacy was achieved in all 11/11 (100%) cases. Ablated volume significantly reduced from 0.87 ± 0.67 ml at first follow-up to 0.17 ± 0.36 at last follow-up (p = 0.003). No change in thyroid function tests occurred. No minor or major complications occurred. All patients graded 10 the satisfaction for the treatment, and mean pain after the procedure was reported as 1.4 ± 1.7, and mean pain after the procedure as 1.2 ± 1.1 At a median follow-up of 10.2 months (range 1.5-12 months), no local recurrence or distant metastases were found. CONCLUSIONS: Image guided thermal ablations appear to be feasible and safe in the treatment of PTMC. These techniques hold the potential to offer patients a minimally invasive curative alternative to surgical resection or active surveillance. These techniques appear to be largely preferred by patients.
目的：报告我们在使用影像引导热消融治疗甲状腺微小乳头状癌（PTMC）患者方面的初步经验，特别是评估其可行性、安全性和短期疗效。
材料与方法：对 2018 年经细胞学证实的直径＜10mm 的 PTMC 患者进行多学科团队讨论，并评估影像引导热消融的可行性。在技术可行的情况下，与患者讨论三种可能的替代方案（即影像引导热消融、手术和主动监测）。同意接受影像引导热消融治疗的患者在局部麻醉和镇静下接受射频（RFA）或激光消融。记录治疗可行性、技术成功率、技术疗效、甲状腺功能检测变化、副作用、轻微和严重并发症、患者满意度、治疗期间和治疗后疼痛/不适感知以及随访期间疾病复发情况。
结果：共评估了 13 例患者，其中 11/13（84.6%）例患者（9 例女性，2 例男性，平均年龄 49.3±8.7 岁）适合影像引导热消融。所有 11 例患者均同意接受影像引导热消融治疗。此外，3/11（27.3%）例患者接受激光消融治疗，8/11（72.7%）例患者接受 RFA 治疗。所有手术均按术前计划完成（技术成功率 100%）。11/11（100%）例患者的技术疗效均达到预期。消融体积从首次随访时的 0.87±0.67ml 显著减少至末次随访时的 0.17±0.36ml（p=0.003）。甲状腺功能检测无变化。无轻微或严重并发症发生。所有患者对治疗满意度评分均为 10 分，术后平均疼痛评分为 1.4±1.7 分，术后 1 天平均疼痛评分为 1.2±1.1 分。在中位随访 10.2 个月（1.5-12 个月）期间，未发现局部复发或远处转移。
结论：影像引导热消融治疗甲状腺微小乳头状癌具有可行性和安全性。这些技术为手术切除或主动监测提供了一种潜在的微创治疗选择，患者更倾向于选择这些技术。
Front Endocrinol (Lausanne). 2020
Front Endocrinol (Lausanne). 2024
Front Oncol. 2022-7-1
J Clin Endocrinol Metab. 2020-6-1
Gland Surg. 2020-1
Zotero 插件