Percutaneous cryoablation of breast tumours in patients with stable metastatic breast cancer: safety, feasibility and efficacy
Percutaneous cryoablation of breast tumours in patients with stable metastatic breast cancer: safety, feasibility and efficacy
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DOI：
10.1259/bjr.20170500
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发表时间：
2018-01-01
影响因子：
2.6
通讯作者：
Mastier, Charles
中科院分区：
文献类型：
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作者：
Beji, Hedi;Pilleul, Frank;Mastier, Charles
目的：评价经皮冷冻消融治疗临床稳定的转移性乳腺癌患者的安全性、可行性和有效性，并将结果与替代手术（即手术和局部放疗）的报告进行比较。（平均年龄54.8岁± 10.8岁;范围37-72岁），由于转移性疾病而未手术治疗的原发性乳腺肿瘤。患者在疾病稳定期接受经皮冷冻治疗原发病灶。使用超声或CT扫描引导进行这种最小干预。所有患者在术前和术后1、3、6和12个月进行临床和乳房MRI评估。原发性病变的平均最大直径为16 ± 12 mm（尺寸范围5-45 mm）。在15例患者中，我们获得了一个完全消退的原发性乳腺病变，在随访期间没有复发。2例病灶直径分别为40 mm和45 mm的患者在随访期间复发。对这2例未纳入本研究的患者进行了第二次冷冻治疗。5例患者在冷冻治疗前有疼痛性肿块。所有的干预后立即缓解，并在所有follow.Conclusion持久：这些结果表明，冷冻消融术的原发性乳腺病变似乎是非常适合姑息治疗的转移性患者，特别是因为其良好的耐受性，低并发症发生率和能力，提供局部或镇痛控制。对于这些原发性乳腺肿瘤转移状态的症状性患者，治疗有限。这项研究表明，冷冻消融术在姑息治疗中是可以实现的，在肿瘤的局部控制是有效的，可以提供即时和长期的镇痛控制。
Purpose: To evaluate safety, feasibility and efficacy of percutaneous cryoablation of breast tumours in patients with clinically stable metastatic breast cancer, and to compare the findings with reports on alternative procedures, namely surgery and local radiotherapy.Methods: 17 female patients (average age of 54.8 years +/- 10.8; range 37-72) with primary breast tumour not surgically treated because of metastatic disease were included. Patients were treated for their primary lesion by percutaneous cryotherapy in period of stable disease. This minimally intervention was performed using ultrasound or CT scan guidance. All patients had clinical and breast-MRI evaluation before and at 1, 3, 6 and 12 months after the procedure.Results: All procedures were performed under local anaesthesia and technically successful. The mean largest diameter of the primary lesions was 16 +/- 12 mm (size range 5-45 mm). In 15 patients, we obtained a complete regression of the primary breast lesion without recurrence during the follow-up period. Two patients with lesions measured at 40 and 45 mm had recurrence in follow up period. A second session of cryotherapy was performed for these 2 patients, not included in this study. Five patients had painful masses before cryotherapy. All were immediately relieved after the intervention and durably during all follow-up.Conclusion: These results show that the cryoablation of primary breast lesions seems to be well suited to the palliative care of metastatic patients, particularly because of its good tolerance, low complication rate and ability to provide local or analgesic control.Advances in knowledge: Therapies are limited for these symptomatic patients at metastatic state of primary breast tumour. This study shows that cryoablation in palliative care is achievable in common practice, is effective in local control of the tumour and can provide immediate and long-term analgesic control.