International Journal of Hyperthermia最新文献

Objective: Surgery and thermal ablation are both viable treatment modalities for patients diagnosed with hyperparathyroidism (HPT). However, the comparative efficacy of these approaches remains uncertain. The objective of this meta-analysis is to evaluate the effectiveness of surgical complications and therapeutic strategies in managing HPT.

Methods: The databases PubMed, EMBASE, the Cochrane Library, the Web of Science, CNKI and Wan Fang were systematically searched from inception to December 12, 2023 to identify relevant studies comparing thermal ablation with surgical parathyroid hormone therapy. Data analysis was conducted using Review Manager Version 5.4.

Result: A total of 15 studies were incorporated into the meta-analysis, comprising 1,115 participants drawn from 12 cohort studies and three randomized controlled trials. The results indicated no significant difference in parathyroid hormone levels between the two treatment options (mean difference: 29.25, 95% CI: -4.99-63.69, p = 0.09), calcium (MD: 0.00, 95%CI: 0.07-0.08, p = 0.94), phosphorus (MD: -0.05, 95% CI: -0.13-0.04, p = 0.28) and the risk of persistence and/or recurrence (OR: 1.01, 95% CI: 0.63-1.62, p = 0.97). The probability of hoarseness (OR: 0.57, 95% CI: 0.35-0.93, p = 0.02) and hypocalcemia (OR: -0.12, 95% CI: -0.19- -0.05, p < 0.01) was lower after thermal ablation than with surgery. Comparable results were observed in instances of secondary and primary hyperparathyroidism.

Conclusion: It can be concluded that surgery and thermal ablation are effective modalities for treating hyperparathyroidism. Thermal ablation has been shown to reduce the likelihood of hoarseness and hypocalcemia. Further validation of these results necessitates conducting comprehensive multicenter randomized controlled trials.

Purpose: To assess the impact of Hashimoto's thyroiditis (HT) on radiofrequency ablation (RFA) outcomes for papillary thyroid microcarcinoma (PTMC).

Methods: A retrospective study of 391 PTMC patients treated with RFA from March 2017 to August 2020, divided by HT accompanied or not. Ablation area size, volume reduction ratio (VRR), lesion disappearance, complications, and recurrences were analyzed.

Results: 391 patients (mean age, 41.3 ± 11.2 [SD]; 317 women, 110 with HT) were evaluated. The follow-up time was 2 years. HT+ PTMC patients (Group A) exhibited larger ablation diameters at 1st and 3rd month post-RFA. In comparison, PTMC patients (Group B) had larger diameters at 1st and 3rd months but smaller at 6th months, returning to baseline around 6th month in Group B and 9th month in Group A. VRRs in Group B were greater than Group A at 3rd, 6th, 9th, 12th and 15th month, all p < 0.05). The Kaplan-Meier curves revealed a slower lesion disappearance rate in A (12th) compared to B group (9th). Complication and recurrence rates were similar for both groups (4.4% and 0.8% overall, Group B vs Group A: 4.3% vs 4.6%, p = 0.905; 0.4% vs 1.8%, p = 0.192).

Conclusion: HT delays the resorption of PTMC lesions following RFA, but it does not impact the procedure's effectiveness or safety. Regardless of HT status, RFA remains a viable alternative to surgery for PTMC.

Objective: To develop and validate a nomogram for predicting the effectiveness of high-intensity focused ultrasound (HIFU) ablation for uterine fibroids based on oxytocin experiments combined with sonographic features.

Methods: Sixty patients with uterine fibroids treated with HIFU combined with oxytocin for uterine fibroids were retrospectively analyzed. Before HIFU treatment, all patients underwent abdominal ultrasonography and oxytocin testing for classification. Predictive factors were selected through univariate and multivariate logistic regression analyses. A predictive model for the clinical efficacy of HIFU treatment of uterine fibroids was established using the R language. The model was visualized by a nomogram, and its discriminative ability, calibration, and clinical value were evaluated.

Results: Types of myomas, classification of blood flow around the myomas, location of the myomas, and classification of oxytocin were selected as the final predictive factors to construct the model. The calibration curve of the nomogram demonstrated good consistency between actual observations and nomogram predictions, with an absolute error of 0.066. The model's discriminative ability was evaluated by the area under the curve, which was 0.887 (95% CI: 0.818-0.955). The sensitivity and specificity were 84.4% and 78.8%, respectively, indicating that the model had a good predictive value for the ablation situation. Decision curve analysis showed that the model had high clinical applicability, with the maximum net benefit threshold probability interval ranging from 12.0% to 80.5%.

Conclusion: The prediction model for HIFU treatment of uterine fibroids, based on ultrasound characteristics and oxytocin test, shows strong predictive ability and may help clinicians choose suitable patients for treatment.

Background/objective: The optimal strategy for patients with colorectal liver metastases is still controversially discussed. This study aimed to evaluate the efficacy of radiofrequency ablation (RFA) combined with systemic chemotherapy plus targeted therapy as first-line treatment in patients with initially unresectable colorectal liver metastases (CRLM), to identify prognostic factors and construct nomograms predicting survival.

Methods: This retrospective study included patients with initially unresectable CRLM treated with (study group n = 74) or without (control group n = 83) RFA at the National Cancer Center from January 2018 to January 2021. Survival curves were assessed using the Kaplan-Meier method and log-rank test. Univariate and multivariate Cox regression analyses were used to determine prognostic factors and include these factors in the nomograms to predict progression-free survival (PFS) and overall survival (OS).

Results: The study group had significantly better median PFS (17.16 months vs. 8.35 months, p < 0.01) and OS (34.9 months vs. 21.1 months, p < 0.01) than the control group after propensity score matching. Cox regression analyses identified RFA treatment and clinical risk score (CRS) as independent prognostic factors for PFS. The largest diameter of liver metastases, RFA treatment, and CRS were independent prognostic factors for OS. Based on this finding, nomograms with good discrimination and calibration were constructed.

Conclusion: RFA combined with systemic chemotherapy plus targeted therapy as first-line treatment could significantly prolong PFS and OS in patients with initially unresectable CRLM compared with systemic chemotherapy plus targeted therapy. The nomograms predicting PFS and OS might help clinicians select personalized treatment.

Objectives: To investigate the significance of the cesarean section diverticulum (CSD) area for predicting the intraoperative massive hemorrhage during suction curettage for cesarean scar pregnancy (CSP) after focused ultrasound ablation surgery (FUAS).

Methods: Data from 90 patients undergoing suction curettage after FUAS were collected. According to their intraoperative bleeding volume, patients were categorized into three groups: Group 1 (n = 71, <200 mL), Group 2 (n = 9, 200-300 mL) and Group 3 (n = 10, ≥300 mL). Multiple liner regression analysis was performed to identify the influencing factors for CSD area and intraoperative blood loss. The ROC curve was plotted to identify the optimal cutoff values.

Results: The median CSD area size in Group 3 (336.8 mm²) was significantly greater than in Groups 1 (128.6 mm²) and 2 (121.6 mm²) (p < .05). Using multiple linear regression analysis, CSD area was associated with intraoperative blood loss (p < .05). The optimal cutoff CSD areas for predicting intraoperative massive hemorrhage volumes ≥ 200 mL and ≥ 300 mL were 202.05 mm² and 241.90 mm², respectively. The mean gestational sac diameter and preoperative symptoms (+) were positively related to CSD area, while residual myometrial thickness was negatively correlated with the CSD area. CSD area showed the greatest relationship to sonication time (r_s = 0.42), treatment time (r_s = 0.316) and total energy used for ablation (r_s = 0.415).

Conclusion: The preoperative CSD area could predict intraoperative massive hemorrhage during suction curettage after FUAS, which might inform therapy strategies for CSP patients.

Background: Heat shock proteins have been implicated in the process of carcinogenesis. HSPA14, a member of the heat shock protein family, remains poorly understood in terms of its significance and pathomechanisms in breast cancer.

Methods: We analyzed the expression levels of HSPA14 and its prognostic significance in breast cancer using TCGA data. TCGA data was used to investigate the association between HSPA14 expression and clinicopathological features in breast cancer patients. GSEA analysis was conducted to identify the biological function of HSPA14. Spearman's correlation analysis was performed to examine the correlation between HSPA14 expression and immune cell infiltration, as well as immune checkpoint genes. Single cell transcriptomic data from GSE114727 was utilized to calculate the expression of HSPA14 in different cell subpopulations. The data on HSPA14 levels and drug sensitivity were extracted from the CellMiner dataset. The mRNA expression of HSPA14 was validated through cell experiments.

Results: HSPA14 expression is elevated in breast cancer, which is associated with poor overall survival. It can serve as a diagnostic biomarker for breast cancer patients. Pathway analysis revealed that HSPA14-associated differential genes are involved in cell cycle, apoptosis, cellular response to heat stress, and more. Additionally, HSPA14 expression is significantly correlated with the immune microenvironment. The expression of HSPA14 may also indicate drug sensitivity.

Conclusion: Our study elucidates the involvement of HSPA14 in tumorigenesis, particularly in modulating the immune response, shaping the immune microenvironment, and contributing to drug resistance, which are pivotal for the development of personalized breast cancer therapies.

Background: Efficacy of current treatment options for cervical cancer require improvement. Previous in vitro studies have shown the enhancing effects of the addition of PARP1-inhibitors to chemoradiotherapy and thermoradiotherapy. The aim of our present study was to test efficacy of different combinations of treatment modalities radiotherapy, cisplatin, hyperthermia and PARP1-inhibitors using in vitro tumor models, ex vivo treated patient samples and in vivo tumor models.

Materials and Methods: In vitro clonogenic survival curves (0-6 Gy) show that PARP1-i (4-5 M Olaparib) enhances both chemoradiotherapy (0.3-0.5 µM cisplatin) and thermoradiotherapy (42 °C for 1 h) in SiHa, CaSki and HeLa cells. A cervical cancer mouse model and freshly obtained in-house developed patient-derived organoids were used to examine the effects of different treatment combinations. For the in vivo study, human cervical cancer (SiHa) cells were injected in the right hind leg of athymic nude mice. In vivo mouse experiments show that PARP1-i enhances thermoradiotherapy or chemoradiotherapy by reduction of tumor volumes. Five cycles of treatment were applied with the following doses per cycle: irradiation 3 Gy, hyperthermia 1 h at 42 °C, cisplatin at 2 mg/kg, and twice PARP1-i at 50 mg/kg.

Results: Quadruple treatment, combining radiotherapy, hyperthermia, cisplatin and PARP1-i, was very effective but also lead to severe side effects causing severe weight loss and death. In contrast, thermoradiotherapy or chemoradiotherapy with addition of PARP1-i, were effective without serious side effects.

Conclusion: The triple combinations are promising options for potentially more effective treatment of locally advanced cervical cancer without more toxicity.

Objectives: The study aimed to develop a non-enhanced MRI-based radiomics model for the preoperative prediction of the efficacy of adenomyosis after high-intensity focused ultrasound (HIFU) treatment.

Methods: The data of 130 patients with adenomyosis who underwent HIFU treatment were reviewed. Based on a non-perfused volume ratio (NPVR) of 50%, the patients were assigned to high ablation rate and low ablation rate groups. A radiomics model was constructed from the screened radiomics features and its output probability was calculated as the radiomics score (Radscore). The clinical-imaging model was constructed from the independent predictors of clinical-imaging characteristics. The combined model was constructed by integrating Radscore and clinical-imaging independent predictors. Receiver operating characteristic (ROC) curves, the Delong test, and decision curve analysis (DCA) were used to evaluate the models.

Results: The combined model had the best overall performance among the three models. The AUC (95% CI), specificity, sensitivity, accuracy, and precision of the combined model were 0.860 (0.786-0.935), 0.780, 0.756, 0.769, 0.738 in the training set, and 0.878 (0.774-0.983), 0.859, 0.667, 0.769, 0.800 in the test set, respectively. The Delong test showed that the performance of both the radiomics and combined models differed significantly from the clinical-imaging model. But the performance of the combined and the radiomics model was statistically equivalent. The DCA indicated that the combined model had better clinical net benefit.

Conclusion: The combined model based on non-enhanced MRI radiomics was effective in predicting the outcome of HIFU ablation of adenomyosis before surgery.

Objective: We conducted the systematic review and meta-analysis to comprehensively compare ablation and surgery in terms of effectiveness, safety and multiple factors affecting life quality of patients with papillary thyroid cancer (PTC).

Methods: PubMed, Embase, Scopus, Web of Science and EBSCO were searched for relevant studies published between January 1980 and September 2023. Two reviewers independently extracted data according to the PRISMA recommendations and assessed the quality of each study with the Cochrane Risk of Bias Tool. Pooled analyses were performed using random or fixed-effects models, as appropriate.

Results: A total of 4829 patients with PTC from 19 eligible studies were included. Through the meta-analysis, similar tumor progression (OR: 1.07; 95% CI 0.78, 1.48; p = 0.66) and recurrence-free survival (OR: 0.86; 95% CI, 0.55, 1.34; p = 0.50) were found between the patients undergoing ablation and those undergoing surgery. More strikingly, the lower risk of major complications (OR: 0.31; 95% CI 0.24, 0.41; p < 0.001), the shorter hospital stay (MD = 3.67 d; 95% CI, -4.89, -2.44; p < 0.001), the abbreviated procedure time (MD: -66.33 min, 95% CI, -77.08, -55.59; p < 0.001), the less intraoperative blood loss (MD: -27.43 ml, 95% CI, -34.60, -20.27; p < 0.001) and the lower treatment cost (MD: -860.42 USD, 95% CI, -1008.03, -712.81; p < 0.001) were noticed in ablation techniques compared to surgical operation. Thermal ablation has shown multiple advantages by virtue of its percutaneous puncture compared with surgical resection.

Conclusion: As an effective, safe, minimally invasive and economical modality, thermal ablation might be a promising alternative to existing PTC management options.

Objective: This study aimed to assess the effectiveness of conventional magnetic resonance imaging (MRI) combined with three-dimensional (3D) ultrasound for the preoperative prediction of nonperfused volume ratio (NPVR) in uterine fibroids after high-intensity focused ultrasound (HIFU) ablation.

Materials and methods: In total, 178 patients who had undergone HIFU ablation therapy for uterine fibroids between July 2021 and August 2023 were enrolled. Baseline clinical, MRI, and 3D ultrasound parameters collected before and after HIFU ablation were analyzed. Multiple linear regression models were constructed for conventional MRI parameters alone and for combined MRI-3D ultrasound parameters to predict NPVR. Paired-sample t-tests and Pearson's correlation were employed to assess relationships between predicted and actual NPVR values. The prediction efficacy of both models was statistically compared.

Results: The combined MRI-3D ultrasound model outperformed the conventional MRI model, with adjusted R² values of 0.597 and 0.553, respectively, both statistically significant (p < 0.05). The combined model revealed that signal intensity on T₂-weighted imaging, degree of enhancement on contrast-enhanced T₁-weighted imaging, maximum distance between the fibroid's dorsal surface and the skin, uterine fibroid vascular network, and fibroid vascularization negatively affected NPVR. The predicted NPVR was significantly correlated with the actual NPVR (p < 0.001).

Conclusions: 3D ultrasound provided essential information for screening fibroids and predicting NPVR before HIFU ablation, serving as a valuable supplement to MRI. The combined MRI-3D ultrasound model shows promise for the preoperative prediction of NPVR in patients with uterine fibroids treated with HIFU and may offer substantial clinical value.