Françoise Bonichon1, Thierry de Baere2, Amandine Berdelou3, Sophie Leboulleux3, Anne-Laure Giraudet4, Marie Cuinet5, Delphine Drui6, Renan Liberge7, Antony Kelly8, Florence Tenenbaum9, Paul Legmann10, Christine Do Cao11, Laurence Leenhardt12, Michel Toubeau13, Yann Godbert14, Jean Palussière15. 1. Department of Nuclear Medicine and Thyroid Oncology, Institut Bergonié, Bordeaux, France. fbonichon@gmail.com. 2. Department of Interventional Radiology, Gustave-Roussy, Villejuif, France. 3. Department of Nuclear Medicine and Endocrine Cancer, Gustave-Roussy, Villejuif, France. 4. Department of Nuclear Medicine, Léon Bérard Center, Lyon, France. 5. Department of Radiology, Léon Bérard Center, Lyon, France. 6. Department of Endocrinology, Institut du Thorax, University Hospital, Nantes, France. 7. Thoracic and General Radiology Department, University Hospital, Nantes, France. 8. Department of Nuclear Medicine, Jean Perrin Center, Clermont Ferrand, France. 9. Nuclear Medicine Service, Hôpital Cochin, 27 rue du Faubourg St Jacques, 75014, Paris, France. 10. Department of radiology, Hôpital Cochin, 27 rue du Faubourg St Jacques, 75014, Paris, France. 11. Department of Endocrinology, University Hospital, Lille, France. 12. Unité Thyroïde Tumeurs Endocrines, Sorbonne Université, AP-HP Hôpital Pitié-Salpêtrière, Paris, France. 13. Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon, France. 14. Department of Nuclear Medicine and Thyroid Oncology, Institut Bergonié, Bordeaux, France. 15. Department of Radiology, Institut Bergonié, Bordeaux, France.
Abstract
PURPOSE: To determine efficacy and safety of thermal ablation (TA) for the local treatment of lung metastases of thyroid cancer. METHODS: We retrospectively studied 47 patients from 10 centers treated by TA (radiofrequency, microwaves, and cryoablation) over 10 years. The endpoints were overall survival (OS), local efficacy, complications (CTCAE classification), and factors associated with survival. OS curves after first TA were built using the Kaplan-Meier method and compared with the log-rank test. RESULTS: A total of 107 lung metastases during 75 sessions were treated by radiofrequency (n = 56), microwaves (n = 9), and cryoablation (n = 10). Median follow-up time after TA was 5.2 years (0.2-13.3). OS was 93% at 2 years (95% confidence interval (CI): 86-94) and 79% at 3 years (95% CI: 66-91). On univariate and multivariate analysis with a Cox model, histology was the only significant factor for OS. OS at 3 years was 94% for follicular, oncocytic, or papillary follicular variant carcinomas, compared to 59% for papillary, medullary, insular or anaplastic carcinomas (P = 0.0001). The local control rate was 98.1% at 1 year and 94.8% at 2, 3, 4, and 5 years. Morbidity was low with no major complications (grade 4 and 5 CTCAE) and no complications in 29 of 75 sessions (38.7%). CONCLUSIONS: TA is a useful, safe and effective option for local treatment of lung metastases from thyroid carcinoma. Prolonged OS was obtained, especially for lung metastases from follicular, oncocytic, or papillary follicular variant carcinomas. Achieving disease control with TA delays the need for systemic treatment.
PURPOSE: To determine efficacy and safety of thermal ablation (TA) for the local treatment of lung metastases of thyroid cancer. METHODS: We retrospectively studied 47 patients from 10 centers treated by TA (radiofrequency, microwaves, and cryoablation) over 10 years. The endpoints were overall survival (OS), local efficacy, complications (CTCAE classification), and factors associated with survival. OS curves after first TA were built using the Kaplan-Meier method and compared with the log-rank test. RESULTS: A total of 107 lung metastases during 75 sessions were treated by radiofrequency (n = 56), microwaves (n = 9), and cryoablation (n = 10). Median follow-up time after TA was 5.2 years (0.2-13.3). OS was 93% at 2 years (95% confidence interval (CI): 86-94) and 79% at 3 years (95% CI: 66-91). On univariate and multivariate analysis with a Cox model, histology was the only significant factor for OS. OS at 3 years was 94% for follicular, oncocytic, or papillary follicular variant carcinomas, compared to 59% for papillary, medullary, insular or anaplastic carcinomas (P = 0.0001). The local control rate was 98.1% at 1 year and 94.8% at 2, 3, 4, and 5 years. Morbidity was low with no major complications (grade 4 and 5 CTCAE) and no complications in 29 of 75 sessions (38.7%). CONCLUSIONS:TA is a useful, safe and effective option for local treatment of lung metastases from thyroid carcinoma. Prolonged OS was obtained, especially for lung metastases from follicular, oncocytic, or papillary follicular variant carcinomas. Achieving disease control with TA delays the need for systemic treatment.
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