León Utrero S, Garrido-Pareja F, López-Ibarra P, Quesada-Charneco M, López-Mezquita E, Ávila-Rubio V, Martín-Rodríguez J L
Department of Endocrinology and Nutrition, University Hospital Clínico San Cecilio, Av. de La Ilustración, s/n, 18016, Granada, Spain.
Department of Radiology, University Hospital Clínico San Cecilio, Av. de La Ilustración, s/n, 18016, Granada, Spain.
J Endocrinol Invest. 2023 Nov;46(11):2269-2273. doi: 10.1007/s40618-023-02078-4. Epub 2023 Apr 9.
Radiofrequency ablation (RFA) has emerged as a minimally invasive approach to single parathyroid adenoma in primary hyperparathyroidism; however, there is limited evidence on its effectiveness.
To evaluate the effectiveness and safety of RFA to treat hyper-functioning parathyroid lesions suggestive of adenomas.
A prospective study was conducted in consecutive patients with primary hyperparathyroidism treated with RFA for single parathyroid lesions in our reference center between November 2017 and June 2021. Pre-treatment (baseline) and follow-up analytical data were gathered on total protein-adjusted calcium, parathyroid hormone [PTH], phosphorus, and 24-h urine calcium. Effectiveness was defined as complete response (normal calcium and PTH), partial response (reduced but not normalized PTH with normal serum calcium), or disease persistence (elevated calcium and PTH). SPSS 15.0 was used for statistical analysis.
Four of thirty-three enrolled patients were lost to the follow-up. The final sample comprised 29 patients (22 females) with mean age of 60.93 ± 13.28 years followed up for a mean of 16.29 ± 7.23 months. Complete response was observed in 48.27%, partial response in 37.93%, and hyperparathyroidism persistence in 13.79%. Serum calcium and PTH levels were significantly lower at 1 and 2 years of post-treatment than at baseline. Adverse effects were mild, with two cases of dysphonia (self-limited in one patient) and no cases of hypocalcaemia or hypoparathyroidism.
RFA may be a safe and effective technique to treat hyper-functioning parathyroid lesions in selected patients.
射频消融术（RFA）已成为治疗原发性甲状旁腺功能亢进症中单发性甲状旁腺腺瘤的一种微创方法；然而，关于其有效性的证据有限。
评估射频消融术治疗提示为腺瘤的功能亢进性甲状旁腺病变的有效性和安全性。
2017年11月至2021年6月期间，在我们的参考中心对连续接受射频消融术治疗单发甲状旁腺病变的原发性甲状旁腺功能亢进症患者进行了一项前瞻性研究。收集了治疗前（基线）和随访时的总蛋白校正钙、甲状旁腺激素[PTH]、磷和24小时尿钙的分析数据。有效性定义为完全缓解（钙和PTH正常）、部分缓解（血清钙正常但PTH降低但未恢复正常）或疾病持续存在（钙和PTH升高）。使用SPSS 15.0进行统计分析。
33例入组患者中有4例失访。最终样本包括29例患者（22例女性），平均年龄60.93±13.28岁，平均随访16.29±7.23个月。观察到完全缓解率为48.27%，部分缓解率为37.93%，甲状旁腺功能亢进持续率为13.79%。治疗后1年和2年时血清钙和PTH水平显著低于基线水平。不良反应轻微，有2例声音嘶哑（1例患者为自限性），无低钙血症或甲状旁腺功能减退病例。
对于部分患者，射频消融术可能是一种治疗功能亢进性甲状旁腺病变的安全有效的技术。
