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超声引导高强度聚焦超声消融治疗硬纤维瘤的安全性和消融效果。

The safety and ablation efficacy of ultrasound-guided high-intensity focused ultrasound ablation for desmoid tumors.

机构信息

State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, PR China.

Department of Surgery, Chongqing Haifu Hospital, Chongqing, PR China.

出版信息

Int J Hyperthermia. 2021 Sep;38(2):89-95. doi: 10.1080/02656736.2021.1894359.

Abstract

OBJECTIVE

To evaluate the safety and efficacy of ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation for desmoid tumors (DTs).

METHOD

A total of 111 patients with histologically proven DTs were included and treated by USgHIFU ablation. Adverse events were continuously evaluated according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 until 3 months after treatment. The incidence of non-perfused areas within the treated tumors, non-perfused volume rate (NPVR) and tumor volume reduction were evaluated using contrast-enhanced MRI before and one week and 3 months after the procedure.

RESULTS

The enrolled patients (32 male, 79 female, mean age 29.5 ± 1.0 years) with 145 DTs (118 extra-abdominal, 16 abdominal wall, 11 intra-abdominal; median maximum diameter: 9.6 cm, range: 3-34.5 cm) underwent 188 sessions of HIFU ablation, and the mean number of ablations was 1.7 (range, 1-7) per patient. In majority of cases (143/145 cases, 98.6%), no serious adverse events were observed. There was no significant difference in the incidence of adverse events between patients who received a single treatment and those who received multiple treatments. Non-perfused area was observed within every treated tumor, and the median NPVR was 84.9% (range, 1.9-100%). The tumor volume reduction rate was 36.1 ± 4.2% at 3 months after treatment.

CONCLUSION

USgHIFU ablation, as a noninvasive and easily repeatable local treatment, is a promising treatment for DTs.

摘要

目的

评估超声引导高强度聚焦超声(USgHIFU)消融治疗硬纤维瘤(DTs)的安全性和有效性。

方法

共纳入 111 例经组织学证实的 DTs 患者,采用 USgHIFU 消融治疗。根据不良事件通用术语标准(CTCAE)v5.0 连续评估不良事件,直至治疗后 3 个月。治疗前、治疗后 1 周和 3 个月,采用增强 MRI 评估治疗肿瘤内无灌注区域、无灌注体积率(NPVR)和肿瘤体积缩小率。

结果

入组患者(32 例男性,79 例女性,平均年龄 29.5±1.0 岁)共 145 个 DTs(118 个位于腹腔外,16 个位于腹壁,11 个位于腹腔内;最大直径中位数:9.6cm,范围:3-34.5cm)共进行了 188 次 HIFU 消融治疗,平均每位患者消融 1.7 次(范围:1-7 次)。在大多数情况下(143/145 例,98.6%),未观察到严重不良事件。单次治疗和多次治疗患者的不良事件发生率无显著差异。每个治疗肿瘤内均观察到无灌注区域,NPVR 中位数为 84.9%(范围:1.9-100%)。治疗后 3 个月肿瘤体积缩小率为 36.1±4.2%。

结论

USgHIFU 消融作为一种非侵入性、可重复的局部治疗方法,是 DTs 有前途的治疗方法。

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