Service d'Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg, 1, place de l'hopital, 67000, Strasbourg, France.
Service d'oto-rhino-laryngologie, Hopitaux Universitaire de Strasbourg, 1, avenue Molière, 67200, Strasbourg, France.
Cardiovasc Intervent Radiol. 2022 Jun;45(6):791-799. doi: 10.1007/s00270-022-03120-3. Epub 2022 Apr 4.
To report techniques and results of 16 cryoablation procedures in 11 patients treated for recurrent head and neck cancer.
This retrospective study reviewed 11 consecutive patients with head and neck cancer recurrence after primary treatment by surgery and radiotherapy, treated with cryoablation between 2016 and 2020. Efficacy was measured by local control rate evaluated on MRI or/and PET. Tumor characteristics, number of cryoprobes, thermoprotective measures and complications were documented.
Sixteen cryoablation procedures were performed in 11 patients with head and neck cancer recurrence after surgery or radiotherapy, deemed ineligible for classic salvage treatment. Among 11 patients, four were treated for an epidermoid carcinoma, four for an adenocarcinoma and three for other types: 1 muco-epidermoid carcinoma, 1 adenoid cystic carcinoma and 1 esthesioneuroblastoma, 10/11 patients had prior surgery, 7/11 patients had prior chemotherapy and 3/11 patients had prior radiotherapy. Median number of cryoprobes was 4, [IQR, 3-6 cryoprobes], thermoprotective measures to protect surrounding organs were required for 10/16 procedures. After cryoablation, local control rate was 45.4% at a mean follow-up of 11.7 months (range 3-34 months). Among the 16 cryoablation procedures, four resulted in complications, two were considered major complications: one septic shock on inhalation pneumopathy during extubation, requiring intensive care; and one dysphonia due to a recurrent nerve injury.
Cryoablation as a salvage treatment for recurrence of head and neck tumors after surgery and/or radiotherapy is an effective option, especially for patients that cannot benefit from salvage surgery.
报告 11 例头颈部复发性癌症患者 16 例冷冻消融治疗的技术和结果。
这项回顾性研究回顾了 2016 年至 2020 年间，11 例因手术和放疗后原发治疗失败的头颈部复发性癌症患者接受冷冻消融治疗的病例。通过 MRI 或/和 PET 评估局部控制率来测量疗效。记录肿瘤特征、冷冻探针数量、热保护措施和并发症。
在 11 例因手术或放疗后复发的头颈部癌症患者中，共进行了 16 例冷冻消融术，这些患者被认为不符合经典挽救治疗的条件。11 例患者中，4 例为表皮样癌，4 例为腺癌，3 例为其他类型：1 例黏液表皮样癌、1 例腺样囊性癌和 1 例嗅神经母细胞瘤；10/11 例患者有既往手术史，7/11 例患者有既往化疗史，3/11 例患者有既往放疗史。冷冻探针中位数为 4 个，[IQR，3-6 个冷冻探针]，需要 10/16 例手术来保护周围器官。冷冻消融后，平均随访 11.7 个月（范围 3-34 个月）时，局部控制率为 45.4%。在 16 例冷冻消融术中有 4 例出现并发症，其中 2 例为严重并发症：1 例在拔管时吸入性肺炎并发感染性休克，需要重症监护；1 例因喉返神经损伤导致声音嘶哑。
冷冻消融作为手术和/或放疗后头颈部肿瘤复发的挽救治疗方法是一种有效的选择，尤其是对于不能从挽救性手术中获益的患者。
