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"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions. .
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Objective To analyze the impact factors of the ablation rate after cryoablation treatment of soft tissue sarcomas.Methods Data of 60 patients with soft tissue sarcomas who underwent cryoablation treatment were analyzed.One month after cryoablation,CT or MR examination was performed to assess the ablation rate.Then statistical analysis was conducted to observe the impact factors on the ablation rate of cryoablation treatment.Results The univariate analysis showed that the largest diameter of tumor and tumor location were related to the ablation rate after cryoablation (x2 =10.408,P=0.015;x2 =36.778,P =0.006),while multivariate analysis showed that tumor location was the independent impact factor on ablation rate of cryoablation treatment for soft tissue sarcoma (P＜0.05).Conclusion Cryoablation is safe and effective in the treatment of soft tissue sarcomas.Tumor location is an independent impact factor on ablation rate of cryoablation for soft tissue sarcomas.
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Objective To explore the efficacy and safety of high intensity focused ultrasound (HIFU) on pancreatic carcinoma. Methods Forty-four patients with pancreatic carcinoma were treated with HIFU. The response rate, clinical beneficial response, overall survival and side effects were evaluated after the treatment. Results The rate of pain relief was 94.74%, the overall 1-, 3-, and 5-years survival rates were 15.91 %, 6. 82%, 2. 27%, respectively;and the median survival time was 8(3～71) months. No complications, such as pancreatisis and gastrointestinal injury occurred. Conclusion HIFU is an effective, non invasive and safe approach in the treatment of pancreatic carcinoma.For the patients with severe condition and intolerable to other methods, HIFU may be a good choice.
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Objective To analysis complications and its associated risk factors of high intensity focused ultrasound (HIFU) in treatment of uterine leiomyoma for selecting rationale indicated patients and reducing complications. Methods Medical documents of 171 patients with 231 leiomyomas in total treated by HIFU were studied retrospectively. Common complications were categorized and analyzed, the relationship between risk factors and complications were studied. Results Common complications in treatment of uterine leiomyomas by HIFU were 71.9% (123/171) of abdominal pain, 17.5% (30/171) of vaginal bloody discharge, 8.2% (14/171) of sacroiliac or buttock pain, 7. 6% (13/171) of skin blister,4. 7% (8/171) of leg pain, 2. 9% (5/171) of hematuria and 1.8% (3/171) of febrile. By logistic regression analysis, the factor correlated with abdominal pain included diameter of uterine leiomyomas,sonication time and average power (P < 0. 05). The factor correlated with sacroiliac or buttock pain was uterine leiomyomas located in posteriors of uterine wall(P <0. 05); the factors correlated with vaginal bloody discharge were sonication time and type of uterine leiomyomas (submucous > intramural > subserous, P <0. 05); the factors correlated with skin blister was sonication time (P < 0. 05). There were no statistical relationship between multiple factors and leg pain, hematuria, febrile (P > 0. 05). Conclusion The modality of high-power and short-term treatment might reduce complications of HIFU ablation.
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Objective To investigate the safety and efficacy of ultrasound ablation in treatment of uterine fibroids. Methods Ninety-nine patients with 117 leiomyomas in total treated by Haifu JC focused ultrasound tumor therapeutic system were enrolled in prospective and non-randomized clinical trial in First Affiliated Hospital of Chongqing Medical University and Academy of Military Medical Sciences. Ultrasound ablation was performed guided by real-time ultrasonography under conscious sedation for single session. All patients were followed up at 6 months after treatment. On the day of treatment and after 1 month, patients were given by magnetic resonance imaging(MRI) exam to evaluate the effect of fibroids ablation. At 3 and 6months after treatment, the ratio of ablated area and volume reduction of fibroids more than 50% were evaluated by MRI exam again. The symptoms improvements were evaluated by uterine fibroid symptom (UFS) and complications were analyzed by guideline of society of international radiation (SIR). Results The average ablated area ratio of the target fibroid was (76 ± 24)%. The average reduction in fibroid volume determined by MRI at 3 and 6 months after treatment was (45 ± 21)% and (59 ± 26)%. Which were significantly decreased than those before treatment (P < 0. 05). At 6 months after treatment, 84. 6% (99/117) of patients showed more than 50% volume reduction, the rate of improved symptom score was 92%(66/72). All patients could resume normal daily activities at 2 hours after treatment. The adverse reactions of SIR C - D included delayed hospitalization, repeat treatment and increased level of nursing. E - F included permanent sequelae and death. In this study, no adverse reactions of C - F were recorded. Common complications (SIR A- B, only observation or simple management without sequelae) were 35% (35/99).Four cases with adverse reactions B of SIR were found, including 2 cases with skin burning of degree Ⅱ and 2 cases with febrile, they were administered by symptomatic therapy and changing dressing The other adverse reaction A of SIR included sorness of buttock, vaginal discharge, dysuria and painful urination, they were only suggested by follow-up. Conclusion It was efficacy and safe that ultrasound ablation as a single strategy were used in treatment of uterine fibroids.
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<p><b>BACKGROUND</b>To investigate the immunohistochemical detected method and the clinical incidence of the bone marrow micrometastases (BMM) in patients with non-small cell lung cancer (NSCLC) and to analyze the sensitivity and specificity and clinical application value.</p><p><b>METHODS</b>Bone marrow samples were collected from the anterior superior iliac spines or posterior superior iliac spines of 53 patients with NSCLC in clinical stage I to III and 15 patients in stage IV, and the BMM was detected by immunohistochemical techniques (IHC) using monoclonal antibodies AE1/AE3 against cytokeratin. Chi-square test was used statistically.</p><p><b>RESULTS</b>The IHC sensitivity could be 10⁻⁵. The BMM positive rate was 22.6% (12/53) in stage I to III and 53.3% (8/15) in stage IV, and there was a significant difference in the BMM positive rate between stage I to III and stage IV (P < 0.05). No correlation was observed between BMM and sex, age, KPS, pathology classification and cancer cell differentiation.</p><p><b>CONCLUSIONS</b>The detection of BMM by IHC is convenient, sensitive, and specific. It might be helpful to diagnose bone marrow micrometastasis in patients with NSCLC.</p>
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Objective To evaluate the safety and clinical efficacy of high intensity focused ultrasound (HIFU) for patients with solid tumors under sedation and analgesia. Methods Sedation and analgesia were induced with i.v. fentanyl(1?g/kg) and midazolam (0.03mg/kg) in 81 patients with benign or malignant solid tumors. High intensity focused ultrasound (HIFU) ablation treatment was then performed. The short-term effect and adverse events of sedatives and analgesics, as well as the effect of HIFU ablation treatment were observed. Results One hundred and twelve HIFU courses were performed on 81 patients, among them 23 patients with benign solid tumors received 26 courses of treatment, and 58 patients with malignant solid tumors, received 86 courses of treatment. A total of 153 foci were targeted. It was estimated that in 81% of all the patients, the tumor size was decreased by 50%, including 72.2%(52/72)of malignant tumors and 97.4%(37/38)of benign tumors. Tumor markers of malignant tumors decreased by more than 50% in 81.3%(13/16) of patients, and remission rate of tumor-related symptoms reached 77.9% (30/39). The adverse events during sedation and analgesia were nausea, reduction in the respiratory rate, visual hallucination, and that of HIFU were pain and swelling. No comblications with severity surpassing grade Ⅲ were found as a result of either sedatives, analgesics or HIFU treatment. Conclusion Sedation and analgesia are relatively safe, effective and feasible during HIFU treatment for solid tumor.