Radiofrequency ablation of liver metastases from breast cancer: Results in 14 patients
Radiofrequency ablation of liver metastases from breast cancer: Results in 14 patients
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DOI：
10.1016/j.jvir.2006.10.014
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发表时间：
2007-01-01
影响因子：
2.9
通讯作者：
Bhatnagar, Sushma
中科院分区：
文献类型：
--
作者：
Gunabushanam, Gowthaman;Sharma, Sanjay;Bhatnagar, Sushma
目得：评估射频消融治疗乳腺癌肝转移瘤的结果。材料与方法：14例乳腺癌患者，16个肝转移瘤，最长径1.1 ~ 4.0 cm（平均1.9 cm），进行前瞻性研究。所有患者既往均接受过化疗。在超声引导下使用17-G内部冷却电极进行射频消融。在12名患者中治疗了单个指标肿瘤，在2名患者中各治疗了2个肿瘤。随访时间为6 ~ 45个月（平均18个月，中位16个月）。无严重并发症发生。在3例患者中观察到轻微并发症或副作用（无症状胸腔积液、肝周积液）。完全坏死，定义为在6个月随访时计算机断层扫描上没有可检测到的疾病，在16个索引肿瘤中有14个（88%）实现。在14例患者中的7例（50%）中观察到由于发生新的转移而导致的治疗失败。5例（36%）患者在射频消融术后的前12个月内死于新发肝转移和肝外转移。在撰写本文时，14例患者中有9例（64%）存活，其中4例患者（29%）无疾病，3例患者（21%）无进展。尽管如此，射频消融似乎是一种安全有效的辅助全身化疗的局部区域治疗乳腺癌肝转移。
PURPOSE: To evaluate the results of radiofrequency ablation in treating hepatic metastases from breast cancer.MATERIALS AND METHODS: Fourteen breast cancer patients with 16 hepatic metastases measuring 1.1 to 4.0 cm in the longest axis (mean, 1.9 cm) were prospectively studied. All patients had previously received chemotherapy. Radiofrequency ablation was done using 17-G, internally cooled electrodes under ultrasound guidance. A single index tumor Was treated in 12 patients, and two tumors each were treated in two patients. Follow-up was done using serial computed tomography for a duration ranging from 6 to 45 months (mean, 18 months; median, 16 months).RESULTS: All patients were treated in a single session. No major complications occurred. Minor complications or side effects (asymptomatic pleural effusion, perihepatic fluid collection) were observed in three patients. Complete necrosis, defined as an absence of detectable disease on computed tomography at 6 months follow-up was achieved in 14 (88%) of 16 index tumors. Treatment failure due to the development of new metastases was observed in seven (50%) of 14 patients. Five (36%) patients died in the first 12 months after radiofrequency ablation due to the development of new hepatic and extrahepatic metastases. At the time of writing, nine (64%) of 14 patients are alive, of whom four patients (29%) are disease-free and three patients (21%) are progression-free.CONCLUSIONS: A high overall treatment failure rate (50%) was observed due to the development of new metastases on follow-up. Despite this, radiofrequency ablation appears to be a safe and effective adjunct to systemic chemotherapy for the loco-regional treatment of liver metastases from breast cancer.