Hieronder mijn vrije vertaling van het originele persbericht met daaronder het volledige studieverslag in het Engels.
Door: David Loshak
Radiofrequency ablation veroorzaakte een complete vernietiging/afsterven van primaire borstkankertumoren in een vroeg stadium. Slechts bij 1 van de 26 patiënten in deze pilotstudie mislukte de behandeling. De behandeling was veilig, met slechts 1 patiënt met een complicatie veroorzaakt door de R.F.A. behandeling.
Deze bevindingen hebben er toe geleid dat aan de universiteit van Texas M. D. Anderson Cancer Center, Houston, Texas, United States, en het G. Pascale National Cancer Institute, Naples, Italy, een volledige trial met slechts alleen Radio Frequency Ablation (dus geen andere operatietechniek) gaan opzetten voor patiënten met T1 en T2 borsttumoren. Dat is inclusief 'sentinel lymph node mapping en post-ablation (sorry weet niet hoe dit te vertalen) vochtafvoer.
De specialisten behandelden 26 patiënten met biopsie bewezen invasieve borstcarcinoom van wie er 20 (77%) T1 tumoren hadden en 6 (23%) T2 tumoren. De patiënten werden met R.F.A. behandeld en daarna direct gevolgd door een operatie. De behandeling was er op gericht de tumoren te vernietigen/vergruizen met een marge van 5mm. om de tumor heen. Gemiddelde behandeltijd van de twee fase R.F.A. behandeling was 15 minuten en 23 seconden( lopend van 6 minuten en 25 seconden tot 24 minuten en 54 seconden).
Volledige vernietiging van de tumor werd bereikt bij 25 van de 26 patiënten. (96%) 1 patiënt had een microscopische levensvatbare plek (micrometastase in mijn eigen woorden) naast de plek waar de naald in de borst ging. De enige complicatie als gevolg van de R.F.A. behandeling deed zich voor bij 1 patiënt die een brandplek op haar huid kreeg doordat de behandelde tumor direct onder de huid lag.
Deze studie is gepubliceerd in: Cancer 2001; 92(8): 2036-2044.
11/05/2001
By David Loshak
Radiofrequency ablation produced complete coagulative necrosis of early-stage, primary breast carcinomas in all but one of the patients in a pilot study of the treatment.
The treatment was safe, with only one complication relating to the radiofrequency ablation.
These initial findings have led specialists at the University of Texas M. D. Anderson Cancer Center, Houston, Texas, United States, and the G. Pascale National Cancer Institute, Naples, Italy, to start a full-scale trial of radiofrequency ablation alone (no resection) for patients with T1 and T2 breast tumours. This will include sentinel lymph node mapping and post-ablation irradiation.
The specialists enrolled 26 patients with biopsy-proven, invasive breast carcinomas of whom 20 (77 percent) had T1 tumours and six (23 percent) had T2 tumours.
The patients underwent radiofrequency ablation of the tumours followed immediately by resection. Treatment was planned to ablate the tumours and a 5 mm. margin of surrounding breast tissue. Tumour viability after radiofrequency ablation was assessed by hematoxylin and eosin and by nicotinamide adenine dinucleotide vital staining.
The mean greatest dimension of tumours treated with radiofrequency ablation was 1.8 cm (range, 0.7-3.0 cm). Mean treatment time for two-phase radiofrequency ablation treatment was 15 minutes and 23 seconds (ranging from six minutes and 25 seconds to 24 minutes and 54 seconds).
Coagulation necrosis of the tumour was complete in 25 of the 26 patients (96 percent). One patient had a microscopic focus of viable tissue next to the needle shaft site.
The sole complication resulting from the radiofrequency ablation was in one patient who had a full thickness burn of the skin overlying a tumour that was immediately beneath the skin.
Cancer 2001; 92(8): 2036-2044. Original Article Radiofrequency ablation in patients with primary breast carcinoma
A pilot study in 26 patients. Francesco Izzo, M.D 1, Renato Thomas, M.D.1, Paolo Delrio, M.D. 1, Massimo Rinaldo, M.D. 1, Paolo Vallone, M.D. 2, Anna DeChiara, M.D. 3, Gerardo Botti, M.D. 3, Giuseppe D'Aiuto, M.D. 1, Pina Cortino, M.D. 1, Steven A. Curley, M.D.4 1Division of Surgical Oncology, The G. Pascale National Cancer Institute, Naples, Italy 2Division of Diagnostic Radiology, The G. Pascale National Cancer Institute, Naples, Italy 3Division of Pathology, The G. Pascale National Cancer Institute, Naples, Italy 4Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas The authors performed a pilot trial of ultrasound-guided percutaneous radiofrequency ablation (RFA) in patients with T1 and T2 breast tumors 1) to confirm complete coagulative necrosis of tumor tissue and 2) to determine the safety and complications related to this treatment.
Twenty-six patients with biopsy-proven, invasive breast carcinoma underwent RFA of their breast tumors followed by immediate resection. Treatment was planned to ablate the tumor and a 5 mm margin of surrounding breast tissue. Tumor viability after RFA was assessed by hematoxylin and eosin and nicotinamide adenine dinucleotide vital staining.
Twenty patients (77%) had T1 tumors, and six patients (23%) had T2 tumors. The mean greatest dimension of tumors that were treated with RFA was 1.8 cm (range, 0.7-3.0 cm). The mean treatment time for two-phase RFA treatment was 15 minutes and 23 seconds (range, from 6 minutes and 25 seconds to 24 minutes and 54 seconds). Coagulation necrosis of the tumor was complete in 25 of 26 patients (96%): One patient had a microscopic focus of viable tissue adjacent to the needle shaft site. A single patient (1 of 26 patients; 4%) had a complication related to RFA: a full thickness burn of the skin overlying a tumor that was immediately beneath the skin.
CONCLUSIONS
This pilot experience with RFA in the treatment of patients with early-stage, primary breast carcinoma revealed that 1) coagulative necrosis of the entire tumor occurred in 96% of the patients, and 2) the treatment was safe, with only a 4% complication rate. The authors have initiated a trial of RFA alone (no resection) for patients with T1 and T2 breast tumors that will include sentinel lymph node mapping and postablation irradiation. Cancer 2001;92:2036-44. © 2001 American Cancer Society.
Received: 27 March 2001; Revised: 15 June 2001; Accepted: 19 July 2001
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