Efficacy and Safety of CT guided Cryoablation after Lipiodol Marking and Embolization for RCC
Efficacy and Safety of CT guided Cryoablation after Lipiodol Marking and Embolization for RCC
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CT 引导下碘油标记和栓塞后冷冻消融治疗肾细胞癌的疗效和安全性
DOI：
10.1080/13645706.2021.2025403
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Yamagami T.
中科院分区：
文献类型：
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作者：
Kajiwara K;Yoshimatsu R;Komoto M;Maeda H;Yamanishi T;Minamiguchi H;Karashima T;Inoue K;Awai K;Yamagami T.
目的评价CT透视引导下经皮冷冻消融术（PCA）在肾细胞癌（RCC）患者脂醇标记栓塞（LME）后的安全性和有效性。材料和方法本研究纳入29例患者（男性18例，女性11例，平均年龄69岁，范围22-89岁），42例rcc。他们于2016年3月至2020年3月期间在LME后接受了CT透视引导下的PCA。肿瘤平均直径为21 mm（范围7 ~ 50 mm）。用脂醇和明胶颗粒进行LME。在消融后的CT扫描中，当冰球包封整个肿瘤且边缘足够时，PCA被认为是成功的。结果40例肿瘤中39例（97.5%）手术成功。39例LME后PCA均成功（100%）。在随访期间（平均13.9±12.1个月），39例肿瘤中有1例（2.6%）发生局部肿瘤进展。37例手术中只有一例（2.7%）出现了明显的并发症（可逆性高血压危象）。前列腺癌术前和术后eGFR分别为64.2±26.8和63.3±26.4 （p= 0.44）。结论使用碘化油和明胶颗粒的lme提高了RCC的可视性，有助于在非增强CT图像上定位肿瘤。LME后PCA可能是一种安全有效的治疗RCC的方法。
PurposeTo evaluate the safety and efficacy of CT fluoroscopy-guided percutaneous cryoablation (PCA) after lipiodol marking and embolization (LME) in patients with renal cell carcinoma (RCC).Material and methodsThis study included 29 patients (18 men, 11 women; mean age 69 years, range 22–89 years) with 42 RCCs. They underwent CT fluoroscopy-guided PCA after LME between March 2016 and March 2020. The mean tumor diameter was 21 mm (range 7–50 mm). LME was performed with lipiodol and gelatin particles. PCA was considered successful when the ice ball encapsulated the entire tumor and the margin was sufficient on post-ablation CT scans.ResultsLME was successfully performed in 39 of 40 tumors (97.5%). PCA after LME was successful in all 39 of 39 tumors (100%). During the follow-up period (mean 13.9 ± 12.1 months), one of the 39 tumors (2.6%) developed local tumor progression. A significant complication (reversible hypertensive crisis) was encountered in only one of 37 (2.7%) procedures. The mean eGFR was 64.2 ± 26.8 before and 63.3 ± 26.4 after PCA (p= .44).ConclusionLME using iodized oil and gelatin particles to improve visualization of the RCC facilitated tumor localization on unenhanced CT images. PCA after LME might be a safe and effective for treatment in patients with RCC.