Vogl Thomas J, Bielfeldt John, Kübler Ulrich, Adwan Hamzah
Clinic for Radiology and Nuclear Medicine, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
Labor Praxisklinik, Weltenburger Str. 70, 81677 Munich, Germany.
Cancers (Basel). 2024 Jun 28;16(13):2373. doi: 10.3390/cancers16132373.
This study shall retrospectively evaluate the efficacy and safety of liquid-nitrogen based CT-guided cryoablation (CA) as a minimal-invasive technique for the curative treatment of primary breast cancer. A total of 45 female patients with 56 tumors were treated by CT-guided CA in analgosedation as an outpatient procedure. We used a liquid-nitrogen based system with a single cryoprobe and performed two freeze cycles with an intermediate thawing. The mean tumor diameter was 1.6 ± 0.7 cm. Follow-up was conducted via contrast-enhanced MR images of the breast. No complications were observed in all 56 ablations. Initial complete ablation was achieved in 100% of cases. Four cases of local tumor progression were reported, resulting in a rate of 8.9%, and 6 cases of intramammary distant recurrence at a rate of 13.3%. The extramammary tumor progression was observed in 7 patients at a rate of 15.6%. The mean overall survival was 4.13 years (95% CI: 3.7-4.5). The mean overall progression-free survival was 2.5 years (95% CI: 1.8-3.2) and the mean local progression-free survival was 2.9 years (95% CI: 2.3-3.6). Cryoablation is a safe and effective treatment for primary breast cancer tumors, which can be performed in analgosedation and as an outpatient procedure. However, potential for improvement exists and further evidence is necessary.
本研究将回顾性评估基于液氮的CT引导下冷冻消融术（CA）作为一种微创技术治疗原发性乳腺癌的疗效和安全性。共有45例患有56个肿瘤的女性患者在镇痛镇静下接受了CT引导下的CA治疗，作为门诊手术。我们使用了基于液氮的系统和单个冷冻探针，进行了两个冷冻周期并中间解冻。肿瘤平均直径为1.6±0.7厘米。通过乳腺对比增强磁共振成像进行随访。在所有56次消融中均未观察到并发症。100%的病例实现了初始完全消融。报告了4例局部肿瘤进展，发生率为8.9%，6例乳腺内远处复发，发生率为13.3%。7例患者出现乳腺外肿瘤进展，发生率为15.6%。平均总生存期为4.13年（95%CI：3.7 - 4.5）。平均无进展总生存期为2.5年（95%CI：1.8 - 3.2），平均局部无进展生存期为2.9年（95%CI：2.3 - 3.6）。冷冻消融术是治疗原发性乳腺癌肿瘤的一种安全有效的方法，可在镇痛镇静下作为门诊手术进行。然而，仍有改进的空间，需要进一步的证据。
