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超声引导经皮微波消融姑息治疗晚期头颈部恶性肿瘤的初步研究。

A preliminary study on ultrasound-guided percutaneous microwave ablation for palliative treatment of advanced head and neck malignancies.

机构信息

Ultrasound Medical Center, Sichuan Cancer Hospital and Research Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.

出版信息

Int J Hyperthermia. 2021;38(1):479-487. doi: 10.1080/02656736.2021.1898683.

Abstract

OBJECTIVE

To evaluate the safety and efficacy of ultrasound (US)-guided percutaneous microwave ablation (UgPMWA) for palliative treatment of advanced head and neck malignancies.

MATERIALS AND METHODS

This study includes 18 consecutive patients with advanced head and neck malignancies ( = 24), who have undergone UgPMWA for palliative treatment at our institution from December 2016 to April 2020. The maximum diameter and volume of the tumor were assessed by US, CT or MRI before microwave ablation (MWA), 1, 3 and 6 months after MWA and every 6 months thereafter. The quality of life was clinically assessed by the University of Washington Head and Neck Quality of Life questionnaire (UW-QOl).

RESULTS

The success rate of tumor-targeting microwave antenna placement was 100%. No nerve injury and serious complications or death occurred during the perioperative period. The follow-up duration varied from 1 month to 38 months (11.56 ± 10.23 months) among patients. By the last follow-up before submission, the value of maximum diameter (5.00 ± 2.90 vs 3.28 ± 2.11 cm.  < 0.05) and tumor volume decreased significantly(74.35 ± 46.88 vs 47.45 ± 24.08 cm.  < 0.05)respectively after palliative treatment with UgPMWA. UW-QOl of the patients was improved (59.24 ± 11.51 vs 69.84 ± 8.12,  < 0.05).

CONCLUSION

UgPMWA is safe and effective for the palliative treatment of head and neck malignancies. Ultrasonic guidance can indicate an accurate location of the microwave antenna. It can also monitor the ablation area in real-time during the operation to avoid damage to surrounding normal tissues.

摘要

目的

评估超声引导经皮微波消融术(UgPMWA)治疗晚期头颈部恶性肿瘤的安全性和有效性。

材料与方法

本研究纳入了 2016 年 12 月至 2020 年 4 月在我院接受 UgPMWA 姑息治疗的 18 例晚期头颈部恶性肿瘤患者(共 24 例病灶)。在微波消融(MWA)前、MWA 后 1、3 和 6 个月以及此后每 6 个月,通过超声、CT 或 MRI 评估肿瘤的最大直径和体积。采用华盛顿大学头颈部生存质量问卷(UW-QOl)进行临床评估。

结果

肿瘤靶向微波天线放置的成功率为 100%。围手术期无神经损伤及严重并发症或死亡发生。患者的随访时间为 1 个月至 38 个月(11.56±10.23 个月)。在提交前的最后一次随访中,最大直径(5.00±2.90 对 3.28±2.11cm,  < 0.05)和肿瘤体积(74.35±46.88 对 47.45±24.08cm,  < 0.05)均较 MWA 姑息治疗前明显减小。患者的 UW-QOl 得到改善(59.24±11.51 对 69.84±8.12,  < 0.05)。

结论

UgPMWA 是治疗头颈部恶性肿瘤的一种安全有效的姑息治疗方法。超声引导可准确指示微波天线的位置,还可在手术过程中实时监测消融区域,避免周围正常组织损伤。

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