Shaikh Raja, Shashi Kumar Kempegowda, Shahin Mohamed M
Department of Radiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.
Department of Radiology, Arkansas Children's Hospital, 1 Children's Way, Little Rock, AR, 72202, USA.
Cardiovasc Intervent Radiol. 2024 Dec;47(12):1776-1783. doi: 10.1007/s00270-024-03845-3. Epub 2024 Sep 5.
To determine the efficacy and safety of cryoablation in pediatric and young adult patients with desmoid tumors (DTs) retrospectively over a 10-year period.
Twenty-one patients (age 2-22 years; median 14 years), with 21 desmoid tumors, underwent a total of 34 percutaneous cryoablation procedures between August 2013 and August 2023. All patients, excluding two, had surgical resection, chemotherapy, or a combination of these therapies with failed or suboptimal response. Clinical and imaging outcomes were analyzed for technical success, change in tumor volume, and recurrence of tumor, symptom improvement or recurrence, and procedure-related complications.
All procedures were technically successful. The median follow-up duration was 9 months (range, 3-32 months); total symptomatic improvement was achieved in 90% (19/21) patients, noticeable pain relief was seen in 100% (18/18) and 90% (9/10) patients had improved range of motion (ROM), discomfort resolved in 66.7% (2/3) patients. Of the treated tumors, 43% (9/21) showed greater than 75% tumor volume reduction of which 44% (4/9) had no evidence of viable residual tumor at follow-up, and 33% (7/21) had 50-75% volume reduction and 14% (3/21) had greater than 40-50% tumor volume reduction. According to modified response evaluation criteria in solid tumors (mRECIST), 71%( 15/21) had partial response (PR), 19% (4/21) had complete response (CR), and 10% (2/21) had stable disease. Four (12%) treatments were associated with minor complications, which self-resolved.
In this, predominantly pediatric patient cohort, cryoablation was effective and safe for the local control of extra-abdominal desmoid tumors in short-term follow-up.
回顾性分析10年间冷冻消融术治疗小儿及青年成人硬纤维瘤（DTs）的疗效和安全性。
2013年8月至2023年8月期间，21例年龄在2至22岁（中位年龄14岁）、患有21个硬纤维瘤的患者共接受了34次经皮冷冻消融手术。除2例患者外，所有患者均接受过手术切除、化疗或这些治疗方法联合使用但效果不佳或反应欠佳。分析临床和影像学结果，包括技术成功率、肿瘤体积变化、肿瘤复发情况、症状改善或复发情况以及与手术相关的并发症。
所有手术在技术上均获成功。中位随访时间为9个月（范围3至32个月）；90%（19/21）的患者症状总体改善，100%（18/18）的患者疼痛明显缓解，90%（9/10）的患者活动范围（ROM）得到改善，66.7%（2/3）的患者不适症状消失。在接受治疗的肿瘤中，43%（9/21）的肿瘤体积缩小超过75%，其中44%（4/9）在随访时无存活残留肿瘤的证据，33%（7/21）的肿瘤体积缩小50%至75%，14%（3/21）的肿瘤体积缩小超过40%至50%。根据实体瘤改良反应评估标准（mRECIST），71%（15/21）患者达到部分缓解（PR），19%（4/21）患者达到完全缓解（CR），10%（2/21）患者病情稳定。4例（12%）治疗出现轻微并发症，均自行缓解。
在这个以儿童患者为主的队列中，冷冻消融术在短期随访中对控制腹外硬纤维瘤有效且安全。
