对无法手术的复发性分化型甲状腺癌进行抢救性射频消融,然后进行体外放射治疗。

IF 3 3区 医学 Q2 ONCOLOGY International Journal of Hyperthermia Pub Date : 2024-01-01 Epub Date: 2024-05-30 DOI:10.1080/02656736.2024.2358054
Chung-Shih Chen, Sheng-Dean Luo, Yen-Hsiang Chang, Chen Kai Chou, Shun-Yu Chi, Shao-Chun Wu, Yen-Hao Chen, Johnson Chia-Shen Yang, Eng-Yen Huang, Yu-Ming Wang, Wei-Che Lin
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引用次数: 0

摘要

目的:复发性甲状腺癌伴有重要器官侵犯的治疗具有挑战性。射频消融(RFA)和体外放射治疗(EBRT)的结合被认为是一种有效的选择。本研究评估了无法手术的残留/复发分化型甲状腺癌(rDTC)患者接受射频消融术和EBRT治疗后的疗效:回顾性研究了接受RFA和EBRT治疗的rDTC患者。在 US 或 CT 引导下,采用徒手 "移动射击 "技术进行 RFA。对于不能耐受 "整体 "高温RFA的侵犯重要结构的病灶,采用6或10-MV光子的有限场EBRT进行辅助治疗,剂量为66 Gy,每天分33次进行。结果:2020年4月至2022年1月期间,11名患者的14个rDTC病灶接受了RFA治疗,随后接受了EBRT治疗。5名患者在确诊为rDTC时已有转移病灶。中位随访时间为 33.7 个月,所有患者均保持了局部控制,2 年生存率达到 90.9%。联合治疗的体积缩小率为92.1% ± 5.1%。治疗后无远处转移的患者的甲状腺球蛋白平均水平为(1.40 ± 0.81)纳克/毫升。在治疗相关并发症方面,1例患者(9%)在RFA治疗后出现暂时性声音嘶哑,3例患者(27.2%)出现2级放射性皮炎,4例患者(36.4%)出现2级吞咽困难。没有出现3级或更严重的毒性反应:抢救性 RFA 后进行 EBRT 对 rDTC 患者是可行、有效和安全的。
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Salvage radiofrequency ablation followed by external beam radiotherapy for inoperable recurrent differentiated thyroid cancer.

Purpose: The treatment of recurrent thyroid cancer with critical organ invasion is challenging. The combination of radiofrequency ablation (RFA) and external beam radiation therapy (EBRT) has been proposed as an effective option. This study evaluates outcomes for inoperable residual/recurrent differentiated thyroid cancer (rDTC) patients treated with RFA followed by EBRT.

Materials and methods: Patients with rDTC treated with RFA followed by EBRT were retrospectively studied. RFA was performed using a free-hand, 'moving-shot' technique under US or CT guidance. For lesions invading critical structures intolerant to 'en bloc' high-temperature RFA, limited-field EBRT using 6- or 10-MV photons was used for adjuvant treatment at a dose of 66 Gy in 33 daily fractions. Toxicities and outcomes were reviewed.

Results: Between April 2020 and January 2022, 11 patients with 14 rDTC lesions underwent RFA followed by EBRT. Five patients had metastatic lesions at rDTC diagnosis. With a median follow-up period of 33.7 months, all patients maintained locoregional control, while achieving a 2-year survival rate of 90.9%. This combined treatment achieved a volume reduction ratio of 92.1% ± 5.1%. The mean nadir thyroglobulin level in patients without initial distant metastases after treatment was 1.40 ± 0.81 ng/ml. Regarding treatment-related complications, one patient (9%) experienced temporary hoarseness after RFA, grade 2 radiation dermatitis occurred in 3 patients (27.2%), and grade 2 dysphagia was noted in 4 patients (36.4%). No grade 3 or greater toxicities occurred.

Conclusions: Salvage RFA followed by EBRT is feasible, effective and safe for patients with rDTC.

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来源期刊
CiteScore
5.90
自引率
12.90%
发文量
153
审稿时长
6-12 weeks
期刊介绍: The International Journal of Hyperthermia
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