Cebula H, Garnon J, Todeschi J, Noel G, Lhermitte B, Mallereau C-H, Chibbaro S, Burckel H, Schott R, de Mathelin M, Gangi A, Proust F
Department of Neurosurgery, University Hospital of Strasbourg, Strasbourg, France.
Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France.
Neurochirurgie. 2022 Apr;68(3):267-272. doi: 10.1016/j.neuchi.2021.11.004. Epub 2021 Dec 11.
Glioblastoma invariably recurs after primary Stupp tumor therapy and portends a poor prognosis. Cryoablation is a well-established treatment strategy for extra-cranial tumors. The safety and efficacy of interventional MR-guided cryoablation (iMRgC) has not been explored in recurrent glioblastoma.
A retrospective analysis of data collected over a period of 24 months was performed. The inclusion criteria were: (I) recurrent glioblastoma despite Stupp protocol; (II) MRI followed by histological confirmation of recurrent glioblastoma; (III) location allowing iMRgC followed by microsurgical resection; and (IV) patient's consent. The primary objective was to assess feasibility in terms of complications. The secondary objective was to analyze progression-free survival (PFS), post-iMRgC survival and overall survival (OS).
The study included 6 patients, with a mean age of 67±7.6 years [range, 54-70 years]. No major complications were observed. Median PFS was 7.5 months [IQR 3.75-9.75] and 6-month PFS was 50%. Median post-iMRgC survival was 9 months [IQR 7.5-15.25] and 6-month post-iMRgC survival was 80%. Median OS was 22.5 months [IQR 21.75-30].
iMRgC for recurrent glioblastoma demonstrated a good safety profile, with no major complications. Our data suggest improved PFS and OS.
No. IRB00011687 retrospectively registred on July 7th 2021.
胶质母细胞瘤在接受原发性施图普肿瘤治疗后总是会复发，预后较差。冷冻消融是一种成熟的颅外肿瘤治疗策略。复发性胶质母细胞瘤中，介入性磁共振引导下冷冻消融（iMRgC）的安全性和有效性尚未得到研究。
对24个月内收集的数据进行回顾性分析。纳入标准为：（I）尽管采用了施图普方案，但仍为复发性胶质母细胞瘤；（II）MRI检查后经组织学证实为复发性胶质母细胞瘤；（III）病变位置允许进行iMRgC，随后进行显微手术切除；（IV）患者同意。主要目的是评估并发症方面的可行性。次要目的是分析无进展生存期（PFS）、iMRgC术后生存期和总生存期（OS）。
该研究纳入了6例患者，平均年龄为67±7.6岁[范围为54 - 70岁]。未观察到重大并发症。PFS中位数为7.5个月[四分位间距3.75 - 9.75]，6个月PFS率为50%。iMRgC术后生存期中位数为9个月[四分位间距7.5 - 15.25]，6个月iMRgC术后生存率为80%。OS中位数为22.5个月[四分位间距21.75 - 30]。
复发性胶质母细胞瘤的iMRgC显示出良好的安全性，无重大并发症。我们的数据表明PFS和OS有所改善。
2021年7月7日追溯注册的IRB00011687号。
