Musculoskeletal Section, Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada; Department of Radiology, Changi General Hospital, Singapore.
Musculoskeletal Section, Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada.
J Vasc Interv Radiol. 2021 Sep;32(9):1277-1287. doi: 10.1016/j.jvir.2021.05.025. Epub 2021 Jun 3.
To determine the efficacy and safety of cryoablation in patients with desmoid tumors (DTs) retrospectively over a 10-year period at a single institution.
Between February 25, 2010, and February 25, 2020, 25 patients (age, 12-80 years) with 26 lesions (mean preprocedural tumor volume was 237 cm) were treated over 44 cryoablation procedures. Eleven patients were treated with first-line therapy. Fourteen patients had previous medical therapy, radiotherapy, and/or surgery. Subsequent clinical follow-up, imaging outcomes, and safety were analyzed for technical success, change in total lesion volume (TLV) and viable tumor volume (VTV), modified response evaluation criteria in solid tumors (mRECIST), progression-free survival (PFS) for tumor progression and symptom recurrence, symptom improvement, and procedure-related complications. Symptomatic improvement was defined as documentation of relief of pain (partial or complete) and/or functional impairment.
All procedures were technically successful. At 7-12 months, median changes in TLV and VTV were -6.7% (P = .809) and -43.7% (P = .01), respectively. At 10-12 months, the mRECIST responses were complete response, 0%; partial response, 61.5% (8/13); stable disease, 30.8% (4/13); and progressive disease, 7.7% (1/13). The median PFS for tumor progression and symptom recurrence were not reached, with a median follow-up of 15.3 and 21.0 months, respectively. Symptomatic relief (partial or complete) was achieved in 96.9% (32/33) of patients. One major complication was noted (2.4%).
In this retrospectively identified cohort, cryoablation was effective and safe for the local control of extra-abdominal DTs in short-term follow-up.
在单家机构回顾性研究了 10 年间冷冻消融治疗腹部外韧带样纤维瘤（desmoid tumors，DTs）的疗效和安全性。
2010 年 2 月 25 日至 2020 年 2 月 25 日，25 例（年龄 12-80 岁）患者的 26 个病灶（术前平均肿瘤体积为 237cm）接受了 44 次冷冻消融治疗。11 例患者接受了一线治疗。14 例患者之前接受过药物治疗、放疗和/或手术。分析了技术成功率、总病变体积（total lesion volume，TLV）和有活力肿瘤体积（viable tumor volume，VTV）的变化、实体瘤改良疗效评价标准（modified response evaluation criteria in solid tumors，mRECIST）、肿瘤进展和症状复发的无进展生存期（progression-free survival，PFS）、症状改善和与手术相关的并发症。症状改善定义为疼痛（部分或完全）缓解和/或功能障碍改善的记录。
所有手术均取得技术成功。在 7-12 个月时，TLV 和 VTV 的中位数变化分别为-6.7%（P=0.809）和-43.7%（P=0.01）。在 10-12 个月时，mRECIST 反应完全缓解为 0%（0/13），部分缓解为 61.5%（8/13），疾病稳定为 30.8%（4/13），疾病进展为 7.7%（1/13）。肿瘤进展和症状复发的中位无进展生存期尚未达到，中位随访时间分别为 15.3 个月和 21.0 个月。96.9%（32/33）的患者获得了症状缓解（部分或完全）。有 1 例严重并发症（2.4%）。
在本回顾性队列研究中，冷冻消融术在短期随访中对于腹部外 DTs 的局部控制是有效且安全的。
