Interstitial laser thermotherapy (ILT) of breast cancer
Interstitial laser thermotherapy (ILT) of breast cancer
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DOI：
10.1016/j.ejso.2008.01.008
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发表时间：
2008-07-01
期刊：
影响因子：
3.8
通讯作者：
Tranberg, K. -G.
中科院分区：
文献类型：
--
作者：
Haraldsdottir, K. H.;Ivarsson, K.;Tranberg, K. -G.
目的：探讨ILT能否作为乳腺癌的根治性治疗方法。方法：对24例浸润性乳腺癌患者进行ILT治疗，年龄39～84岁（平均61岁）。所有患者在治疗前均接受了乳房X光检查、超声检查和核心活检。 15 名患者的肿瘤为浸润性导管癌，8 名患者的肿瘤为小叶癌，1 名患者的肿瘤为小叶导管癌。超声显示肿瘤平均直径为 14 毫米 (5-35)。患者在局部麻醉下在门诊接受治疗。 19 名患者在超声引导下放置探头，并使用温度反馈控制，在 48 摄氏度的稳态温度下使用二极管激光器进行 ILT，持续 30 分钟。 ILT 后 12 (4-23) 天进行标准手术切除，然后进行多普勒超声检查。结果：治疗引起的浸润性癌症坏死率为 33%（范围 0-100），并且 3 名患者完全坏死。在术前随访中，尽管治疗后肿瘤血流消失，导致大面积坏死，但超声无法判断激光损伤的程度。治疗效果与投票率大小呈负相关。 ILT的无效主要是由于乳房X线照相术和超声检查低估了肿瘤大小，以及这些方法在显示肿瘤边界、肿瘤不规则性和原位癌（CIS）方面的缺点。 ILT 耐受性良好。治疗后第一天，五名患者出现乳房压痛，三名患者出现疼痛。 2例患者出现小皮肤坏死。结论：ILT可以根治小乳腺癌。该方法可能在乳腺癌的治疗中有用，但如果要用于根治性治疗，即使对于边界明确的小型乳腺癌，也需要进一步完善。 (C) 2008 Elsevier Ltd. 保留所有权利。
Aim: To find out if ILT can be used as radical treatment of breast cancer.Method: Twenty-four patients, aged 39-84 (mean 61), with invasive breast cancer were treated with ILT. All underwent mammography, ultrasound and core biopsy before treatment. The tumour was an invasive ductal carcinoma in 15 patients, a lobular carcinoma in eight and lobular-ductal cancer in one. Average tumour diameter was 14 mm on ultrasound (5-35). Patients were treated in the outpatient clinics under local anaesthesia. Probes were placed under ultrasound guidance, in 19 patients, and ILT was performed with a diode laser at a steady-state temperature of 48 degrees C for 30 min using temperature feedback control. Standard surgical excision was performed 12 (4-23) days after ILT and was preceded by Doppler ultrasound.Results: Treatment-induced necrosis of invasive cancer was 33% (range 0-100) and was complete in three patients. At follow-up before surgery, the extent of laser damage could not be judged with ultrasound, although abolished tumour blood flow was demonstrated after treatment resulting in large necroses. Efficacy of treatment varied negatively with turnout size. The inefficacy of ILT was mainly due to the underestimation of tumour size by mammography and ultrasound and the shortcomings of these methods to demonstrate tumour borders, tumour irregularity and carcinoma in situ (CIS). ILT was well tolerated. Five patients had breast tenderness, and three patients had pain, during the first day after treatment. Small skin necroses were observed in two patients.Conclusion: Small breast cancers can be treated radically with ILT. The method may become useful in the treatment of breast cancer but needs further refinement, even for small well-defined breast cancers, if it is going to be employed for radical treatment. (C) 2008 Elsevier Ltd. All rights reserved.