Safety and efficacy analysis of ultrasound-guided microwave ablation for pediatric recurrent aggressive fibromatosis.

IF 2.8 3区医学 Q1 ORTHOPEDICS Journal of Orthopaedic Surgery and Research Pub Date : 2025-02-12 DOI:10.1186/s13018-025-05563-z

Hongxia Zhang, Linya Lv, Xin Li, Shuting Huang, Zhenzhen Zhao, Xiangru Kong

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Abstract

Background: The treatment of aggressive fibromatosis (AF) poses a challenge for physicians due to propensity for local recurrence and aggressive nature, with traditional surgical excision often resulting in recurrence. Ultrasound-guided ablation, offering minimal trauma and reusability, has emerged as a novel therapeutic option for invasive fibromas. We report our experience of microwave ablation (MWA) as a local and analgesic treatment for inoperable or recurring AF.

Methods: This study includes 8 patients who underwent percutaneous MWA of 10 AF between November 2021 and November 2023. All patients underwent pain assessment using a visual analog scale (VAS) and preoperative imaging. Patients received clinical and radiological follow-up at 6 months post-procedure, with pain-rating and adverse events being recorded. A long-term follow-up was achieved until 1 November 2024.

Results: In this study, the 10 tumors in 8 patients have a preoperative size ranging from 1.84 to 477.96 ml, with a mean of 71.90 ± 147.55 ml. Postoperatively, at 6 months, the lesion sizes ranged from 0 to 174.99 ml, with a mean of 24.97 ± 53.78 ml (P < 0.05). The mean volume reduction ratio (VRR) was 55.86% (range 15.48-100%), with an overall treatment effectiveness rate of 80% (8 out of 10). Long-term follow-up revealed 2 cases meeting complete response (CR) criteria, 4 cases achieving partial response (PR), and 2 cases meeting stable disease (SD) criteria. The average pre-treatment VAS score among the 8 patients was 6.38 (range 5-9), which decreased to 3.0 (range 0-6) after 1 month of treatment, demonstrating a significant average pain reduction of 3.38 (p < 0.05). The study reported an adverse reaction incidence of 12.5% (1/8) due to neural heat damage from ablation, with symptom improvement following supportive care.

Conclusion: MWA is an effective therapeutic option for the local treatment and for the analgesic management of AF.

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超声引导下微波消融治疗小儿复发性侵袭性纤维瘤病的安全性及疗效分析。

背景：侵袭性纤维瘤病（invasive fibromatosis， AF）具有局部复发的倾向和侵袭性，传统的手术切除往往导致复发，对医生的治疗提出了挑战。超声引导消融，提供最小的创伤和可重复使用，已成为一种新的治疗选择浸润性纤维瘤。我们报告了微波消融（MWA）作为不能手术或复发性房颤的局部镇痛治疗的经验。方法：本研究包括8例在2021年11月至2023年11月间经皮MWA治疗10例房颤的患者。所有患者均采用视觉模拟评分（VAS）和术前成像进行疼痛评估。术后6个月对患者进行临床和影像学随访，记录疼痛程度和不良事件。在2024年11月1日之前进行了长期随访。结果：本组8例患者10例肿瘤术前大小为1.84 ~ 477.96 ml，平均为71.90±147.55 ml，术后6个月病变大小为0 ~ 174.99 ml，平均为24.97±53.78 ml (P)结论：MWA是AF局部治疗和镇痛管理的有效治疗选择。

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来源期刊

Journal of Orthopaedic Surgery and Research ORTHOPEDICS-

CiteScore

4.10

自引率

7.70%

发文量

494

审稿时长

>12 weeks

期刊介绍： Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues. Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications. JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.