RESUMEN
OBJECTIVE: To evaluate the feasibility, efficiency, and safety of microwave ablation (MWA) for T1N0M0 multifocal (≤ 3) papillary thyroid carcinoma (PTC). METHODS: This was a retrospective study, and patients who underwent MWA for multifocal (≤ 3) PTC were reviewed between October 2016 and December 2020. After ablation, the changes in tumor size and volume, as well as the rate of technical success, tumor disappearance, disease progression, and complications were assessed. RESULTS: There were a total of 57 cases enrolled in the present study, which included 18 males and 39 females. The mean age was 44 ± 11 years (22-66 years); the mean follow-up time was 18 ± 11 months (6-48 months). Complete ablation was achieved in all enrolled cases. Therefore, the technical success rate was 100%. Due to expanding ablation, the MD and volume of the ablation zone, as well as the VRR, increased at the 1st and 3rd months after ablation and decreased at 12 and 18 months after ablation (p < 0.05 for all). The total complete tumor disappearance rate was 43.9% (25/57), including 54% (24/44) in the T1a subgroup vs. 7.7% (1/13) in the T1b subgroup (p = 0.003). The total disease progression rate was 7% (4/57), including 9.1% (4/44) in the T1a subgroup vs. 0% (0/13) in the T1b subgroup (p = 0.142). The overall complication rate was 5.3% (3/57), including 6.8% (4/44) in the T1a subgroup vs. 0% (0/13) in the T1b subgroup (p = 0.206). CONCLUSION: This preliminary study indicates that MWA is a safe and effective treatment for T1N0M0 multifocal (≤ 3) PTC. KEY POINTS: ⢠MWA is a promising alternative method for T1N0M0 multifocal (≤ 3) PTC.
Asunto(s)
Ablación por Catéter , Neoplasias de la Tiroides , Masculino , Femenino , Humanos , Adulto , Persona de Mediana Edad , Cáncer Papilar Tiroideo/cirugía , Estudios Retrospectivos , Microondas/uso terapéutico , Resultado del Tratamiento , Neoplasias de la Tiroides/cirugía , Neoplasias de la Tiroides/patología , Progresión de la Enfermedad , Ablación por Catéter/métodosRESUMEN
PURPOSE: To study the feasibility, safety, and effectiveness of microwave ablation (MWA) in patients with multifocal papillary thyroid microcarcinoma (PTMC). MATERIALS AND METHODS: This retrospective study included patients who underwent MWA for multifocal PTMC (number of nodules ≤3). A total of 44 patients were included, and the mean age was 43 years (SD ± 11). After ablation, progression-free survival (PFS) at 6, 12, 24, 36, and 48 months; disease progression; change in tumor size and volume; tumor disappearance rate; and adverse events (AEs) were assessed, and the feasibility, safety, and effectiveness of MWA for PTMC were evaluated on the basis of statistical analysis. RESULTS: The median follow-up period was 18 months (interquartile range, 12-33 months). The PFS rates at 6, 12, 24, 36, and 48 months were 100.0%, 96.4%, 96.4%, 70.3%, and 52.7%, respectively. The disease progression rate was 11.4% (5 of 44 patients). The maximum diameter (MD) and volume of the ablation zone were larger at the 3-month follow-up than before ablation (median MD, 13.0 vs 7.0 mm; P < .001; median volume, 503.8 vs 113.0 mm3; P < .001). Subsequently, the tumors exhibited a reduction in both size and volume after 18 months (median MD, 4.0 vs 7.0 mm; P = .04; median volume, 12.6 vs 113.0 mm3; P = .055). At the end of the follow-up period, the complete response rate was 59% (26 of 44 patients). The overall AE rate was 6.8%. CONCLUSIONS: MWA is a feasible treatment for PTMC (number of nodules ≤3), and this study preliminarily demonstrated the safety and effectiveness of this technique.
Asunto(s)
Microondas , Neoplasias de la Tiroides , Humanos , Adulto , Estudios Retrospectivos , Microondas/efectos adversos , Neoplasias de la Tiroides/diagnóstico por imagen , Neoplasias de la Tiroides/cirugía , Progresión de la Enfermedad , Resultado del TratamientoRESUMEN
OBJECTIVE: To evaluate the efficacy and safety of thermal ablation in treating solitary low-risk T2N0M0 papillary thyroid cancer (PTC) and compare the outcomes of microwave ablation (MWA) and radiofrequency ablation (RFA). MATERIALS AND METHODS: This retrospective, single center study involved 34 patients (age: 40.0 ± 13.9 years; 28 female) who had low-risk T2N0M0 PTC with a maximum diameter >2 cm and ≤4 cm and underwent MWA (n = 15) or RFA (n = 19) from November 2016 to April 2023. The primary outcomes were the cumulative rate of disease progression and delayed surgery rates. In contrast, the secondary outcomes included changes in tumor size, cumulative rate of complete tumor disappearance, and complication rates. RESULTS: The median follow-up period was 18.0 months (interquartile range [IQR]: 9.0-40.0 months). At 12 months, the median volume reduction rate of the ablation zone was 74.2% (IQR: 53.7%-86.0%). Disease progression was noted in two patients within 1 year, including one patient with local tumor progression post-RFA and one with a new tumor post-MWA, resulting in a constant cumulative disease progression rate of 8.8% (95% confidence interval [CI]: 0%-19.8%) throughout the remaining follow-up period. Both patients were subsequently treated with additional ablation and did not require surgery. The cumulative rates of complete tumor disappearance at 1, 3, and 5 years were 4.0% (95% CI: 0%-11.4%), 26.8% (95% CI: 2.7%-44.9%), and 51.2% (95% CI: 0%-79.1%), respectively. No significant differences were observed in the disease progression (P = 0.829) or complete tumor disappearance (P = 0.633) rates between the MWA and RFA groups. Complications occurred in 14.7% (5/34) of patients presenting with transient hoarseness. RFA had a higher but not statistically significant complication rate than MWA did (21.1% [4/19] vs. 6.7% [1/15]; P = 0.355). CONCLUSION: Both MWA and RFA demonstrated promising short-term outcomes in terms of efficacy and safety in treating solitary low-risk T2N0M0 PTC, with no significant differences.
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Microondas , Ablación por Radiofrecuencia , Cáncer Papilar Tiroideo , Neoplasias de la Tiroides , Humanos , Femenino , Masculino , Cáncer Papilar Tiroideo/cirugía , Cáncer Papilar Tiroideo/patología , Estudios Retrospectivos , Adulto , Neoplasias de la Tiroides/cirugía , Neoplasias de la Tiroides/patología , Microondas/uso terapéutico , Ablación por Radiofrecuencia/métodos , Resultado del Tratamiento , Persona de Mediana Edad , Progresión de la Enfermedad , Estadificación de NeoplasiasRESUMEN
RATIONALE AND OBJECTIVES: To evaluate the feasibility, efficiency, and safety of microwave ablation (MWA) for multifocal papillary thyroid microcarcinoma (PTMC). METHODS: This was a retrospective study, and the data of patients who underwent MWA for multifocal PTMC from October 2016 to December 2021 were reviewed. After ablation, the changes in tumor size and volume, as well as the rates of technical success, tumor disappearance, disease progression, and complications, were assessed. According to the tumor location, the cases were further divided into a unilateral multifocal disease (UMD) subgroup and a bilateral multifocal disease (BMD) subgroup. Further analyses were carried out. RESULTS: There was a total of 94 cases enrolled in the present study, which included 24 males and 70 females. The median age was 40 years (22-66 years); the median follow-up time was 14 months (6-48 months). Complete ablation was achieved in all enrolled cases. Therefore, the technical success rate was 100%. Due to expanding ablation, the MD and volume of the ablation zone increased at the 1st and 3rd months after ablation and decreased from the 12th month after ablation (p < 0.05 for all). The total complete tumor disappearance rates were 45/94 (47.87%) overall, 40.625% (13/32) in the UMD subgroup and 51.61% (32/62) in the BMD subgroup (p = 0.312). The total disease progression rates were 4.26% (4/94) overall, 6.25% (2/32) in the UMD subgroup and 3.23% (2/62) in the BMD subgroup (p = 0.881). The overall complication rate was 4.26% (4/94). CONCLUSION: This preliminary study indicates that MWA is a safe and effective treatment for multifocal PTMC.
Asunto(s)
Carcinoma Papilar , Microondas , Neoplasias de la Tiroides , Humanos , Femenino , Masculino , Persona de Mediana Edad , Adulto , Microondas/uso terapéutico , Neoplasias de la Tiroides/cirugía , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/diagnóstico por imagen , Estudios Retrospectivos , Anciano , Carcinoma Papilar/cirugía , Carcinoma Papilar/diagnóstico por imagen , Resultado del Tratamiento , Estudios de Factibilidad , Adulto Joven , Técnicas de Ablación/métodosRESUMEN
Hydroxyapatite (HA) bioceramic coating has been extensively applied for the modification of metallic implants to improve their biocompatibility and service life after implantation. Unfortunately, HA coating often suffers from high friction, severe wear, and bacterial invasion, which restrict its application in artificial joints. According to a bioinspired soft/hard combination strategy, a novel HA composite coating that is infiltrated with a vancomycin-loaded graphene oxide (GO) hybrid supramolecular hydrogel is developed via vacuum infiltration and a subsequent host-guest interaction-induced self-assembly process. The holes of textured HA ceramic coating act just like a "magic pocket", offering a stable container to form and store GO hybrid hydrogels and even to recycle wear debris as well. The drug-loaded hybrid hydrogels stored in textured HA coating possess a unique shear force and/or frictional heat triggered gel-sol transition and sustained drug release behavior, acting like the extrusion of synovial fluid during articular cartilage movement, leading to a remarkable self-lubrication, anti-wear performance, and promising antibacterial property against Staphylococcus aureus. The friction coefficient and wear rate of composite coating reduced by nearly five times and three orders of magnitude compared with textured HA coating, respectively, which benefited from the synergistic lubricate effect of cyclodextrin-based pseudopolyrotaxane supramolecular hydrogel and GO lubricants.
Asunto(s)
Grafito , Hidrogeles , Antibacterianos/farmacología , Durapatita/farmacología , Grafito/farmacología , Hidrogeles/farmacologíaRESUMEN
In the present work, Eu(NO3)3 and Tb(NO3)3 complexes with a diamide ligand 1,6-bis[(2'-benzylaminoformyl)phenoxyl]hexane (L) were prepared in the solution of chloroform and ethyl acetate. Their mixed complexes with different molar ratio also synthesized by coprecipitation. Eu and Tb complexes were mixed with different molar ratio, mechanically ground, and a series of mixed solid complexes were obtained. These mixed complexes were characterized by elemental analysis, UV-Vis, IR and XPS spectra. The analytical data were obtained by a Vario EL CHN and indicated that Eu and Tb complexes formed a 2:3 metal-to-ligand stoichiometries 2RE(NO3)3 x 3L x 4H2O. Their IR spectra were recorded on a Bruke FTS66V/S spectrophotometer. The results indicate that all complexes have similar IR spectra, of which the characteristic bands have similar shifts, suggesting that they have a similar coordination structure. UV-Vis spectra were recorded on a Hitachi U-3010 spectrophotometer and showed that under the influence of the mixed ions, the absorbance of the mixed complexes is not identical with that of the pure complexes. XPS spectra were analyzed on a PHI-5702 X-ray photoelectron spectroscope (XPS) operating with monochromatic Mg K alpha irradiation at pass energy of 29.4 eV. The binding energies of O (1s), Eu (3d) and Tb (4d) in the two kinds of mixed complexes were changed compared with Eu-L and Tb-L complexes. This indicates that these two synthetic methods were not a simple physical mixing process, but there was some chemical effect between the mixed Eu-L and Tb-L complexes. The fluorescence spectra of the mixed complexes were obtained on a Hitachi F-4500 spectrophotometer at room temperature. The excitation and emission slit widths was 1.0 nm. It was concluded from the excitation spectra that the best excitation wavelengths for Eu and Tb complexes are 396 and 320 nm respectively. For the convenience of comparing the fluorescence intensities with each other, the excitation wavelengths were set to 320 nm. For the mixed complexes prepared by coprecipitation, the peak positions of the 5 D4-->7 F6 and 5 D4-->7 F5 transitions were not changed. The peak at 590 nm was assigned to the 5D0-->7 F1 and 5 D4-->7 F4 transitions. Its position is dependent on the content of Eu and Tb complexes. When the content of Eu complex is large, this peak is near to the position of the 5 D0-->7 F1 transition, but when the content of Tb complex is large, it is near to the position of the 5 D4-->7 F4 transition. The peak at 620 nm is a combined peak of the 5 D0-->7 F2 and 5 D4-->7 F3 transitions. It has a similar change with the peak at 590 nm. The change of these peak positions could indicate that there was interaction between Eu and Tb complexes. The fluorescence intensities of the mixed solid complexes were changed obviously as compared with the pure Eu and Tb complexes. The fluorescence intensities of their 5 D4-->7 F6 and 5 D4-->7 F5 transitions were lower than those of the Tb complex as well as the theoretical values calculated by the molar ratio of Tb complex, and decreased with the increase in the content of Eu complex, which shows that the fluorescence intensities of terbium ions were quenched by europium ions. The fluorescence intensities of the two combined peaks at 590 and 620 nm are higher than that of Eu complex but lower than that Tb complex and they increased with the increase in the content of Tb complex, which indicates that the fluorescence intensities of Eu3+ were sensitized by Tb3+. In the mixed complexes prepared by grinding, the fluorescence intensities of Eu3+ were also sensitized by Tb3+ and the fluorescence intensities of Tb3+ are also quenched by Eu3+. Under the excitation of UV light, the mixed complexes resulted by coprecipitation exhibit different fluorescence color.