Gambelunghe Giovanni, Stefanetti Elisa, Avenia Nicola, De Feo Pierpaolo
Endocrine Unit, Clinica Liotti, 06123 Perugia, Italy.
Studio Tiroide Prof. De Feo, 06132 Perugia, Italy.
J Endocr Soc. 2021 May 5;5(7):bvab081. doi: 10.1210/jendso/bvab081. eCollection 2021 Jul 1.
Percutaneous, ultrasound-guided laser ablation is effective in nodular thyroid disease.
The aim of this study was to evaluate the long-term (10-year) efficacy and safety of laser ablation in the treatment of benign thyroid nodules.
From 2009 to 2010, 171 patients received a single session of laser ablation. Evaluation of nodule volume was performed before treatment, at 6 months, and every year.
Technique efficacy was achieved in 92% of patients at 1 year. Median nodule volume significantly decreased from 16.7 mL (range, 11.0-97.0 mL) at baseline to 5.0 mL (range, 4.1-32.0 mL) at 1 year, a volume reduction ratio (VRR) of 68%. The benefit of the treatment was durable ( < 0.001 vs baseline at all timepoints), with a VRR of 59% after 10 years. No cases of nodule regrowth > 50% were observed at 1 year, although such cases did occur after 4 years (n = 3; 1.7% of the overall cohort) and 7 years (n = 8; 4.7%). There were no further cases of regrowth beyond 7 years. When patients were stratified according to baseline nodule volume (< 15 mL, 15-25 mL, or > 25 mL), durable results were observed across all 3 categories, with the largest, most prolonged effect observed in patients with nodules < 15 mL. Treatment was well tolerated, with only minor, transient complications of fever and local pain, and 98% of patients willing to recommend the treatment.
Percutaneous, ultrasound-guided laser ablation of benign thyroid nodules provides long-term benefits and the treatment is well tolerated.
经皮超声引导下激光消融术对结节性甲状腺疾病有效。
本研究旨在评估激光消融术治疗良性甲状腺结节的长期（10年）疗效和安全性。
2009年至2010年，171例患者接受了单次激光消融治疗。在治疗前、6个月时以及每年对结节体积进行评估。
1年后92%的患者实现了技术疗效。结节体积中位数从基线时的16.7 mL（范围11.0 - 97.0 mL）显著降至1年时的5.0 mL（范围4.1 - 32.0 mL），体积缩小率（VRR）为68%。治疗效果持久（所有时间点与基线相比，P < 0.001），10年后VRR为59%。1年时未观察到结节再生长超过50%的病例，尽管4年后出现了此类病例（n = 3；占总队列的1.7%），7年后也出现了（n = 8；占4.7%）。7年后未再出现进一步的再生长病例。当根据基线结节体积（< 15 mL、15 - 25 mL或> 25 mL）对患者进行分层时，在所有3个类别中均观察到了持久的效果，在结节< 15 mL的患者中观察到的效果最大且持续时间最长。治疗耐受性良好，仅出现轻微、短暂的发热和局部疼痛并发症，98%的患者愿意推荐该治疗方法。
经皮超声引导下激光消融良性甲状腺结节可带来长期益处，且治疗耐受性良好。
