PDF(Pubmed)
Abstract：
OBJECTIVE: Hepatic epithelioid hemangioendothelioma (HEHE) is a rare tumor with currently no established standard of care. This international multicenter retrospective study assesses the use of percutaneous irreversible electroporation (IRE) as an ablative tool to treat HEHE and provides a clinical overview of the current management and role of IRE in HEHE treatment.
METHODS: Between 2017 and 2023, 14 patients with 47 HEHE tumors were treated with percutaneous IRE using CT-scan guidance in 23 procedures. Baseline patient and tumor characteristics were evaluated. Primary outcome measures included safety and effectiveness, analyzed using Common Terminology Criteria for Adverse Events (CTCAE) and treatment response by mRECIST criteria. Secondary outcome measures included technical success, post-treatment tumor sizes and length of hospital stay. Technical success was defined as complete ablation with an adequate ablative margin (intentional tumor free ablation margin > 5 mm).
RESULTS: IRE treatment resulted in technical success in all tumors. Following a median follow-up of 15 months, 30 tumors demonstrated a complete response according to mRECIST criteria. The average tumor size pre-treatment was 25.8 mm, accompanied by an average reduction in tumor size by 7.5 mm. In 38 out of 47 tumors, there was no evidence of local recurrence. In nine tumors, residual tumor was present. There were no cases of progressive disease. Median length of hospital stay was one day. Only one grade 3 CTCAE event occurred, a pneumothorax requiring chest tube placement.
CONCLUSIONS: The current study provides evidence that IRE is a safe and efficacious minimally invasive treatment option for HEHE.
METHODS: Between 2017 and 2023, 14 patients with 47 HEHE tumors were treated with percutaneous IRE using CT-scan guidance in 23 procedures. Baseline patient and tumor characteristics were evaluated. Primary outcome measures included safety and effectiveness, analyzed using Common Terminology Criteria for Adverse Events (CTCAE) and treatment response by mRECIST criteria. Secondary outcome measures included technical success, post-treatment tumor sizes and length of hospital stay. Technical success was defined as complete ablation with an adequate ablative margin (intentional tumor free ablation margin > 5 mm).
RESULTS: IRE treatment resulted in technical success in all tumors. Following a median follow-up of 15 months, 30 tumors demonstrated a complete response according to mRECIST criteria. The average tumor size pre-treatment was 25.8 mm, accompanied by an average reduction in tumor size by 7.5 mm. In 38 out of 47 tumors, there was no evidence of local recurrence. In nine tumors, residual tumor was present. There were no cases of progressive disease. Median length of hospital stay was one day. Only one grade 3 CTCAE event occurred, a pneumothorax requiring chest tube placement.
CONCLUSIONS: The current study provides evidence that IRE is a safe and efficacious minimally invasive treatment option for HEHE.
摘要：
目的：肝上皮样血管内皮瘤（HEHE）是一种罕见的肿瘤，目前尚无既定的治疗标准。这项国际多中心回顾性研究评估了经皮不可逆电穿孔（IRE）作为治疗HEHE的消融工具的使用，并提供了IRE在HEHE治疗中的当前管理和作用的临床概述。
方法：在2017年至2023年之间，在23例手术中，使用CT扫描引导经皮IRE治疗了14例47例HEHE肿瘤患者。评估基线患者和肿瘤特征。主要结果指标包括安全性和有效性，使用不良事件通用术语标准(CTCAE)和mRECIST标准的治疗反应进行分析。次要结果指标包括技术成功，治疗后肿瘤大小和住院时间。技术成功定义为具有足够消融边缘的完全消融（有意无肿瘤消融边缘>5mm）。
结果：IRE治疗导致所有肿瘤的技术成功。经过15个月的中位随访，根据mRECIST标准,30个肿瘤显示完全响应。治疗前肿瘤平均大小为25.8mm,伴随着肿瘤大小平均减少7.5毫米。在47个肿瘤中，有38个，没有局部复发的证据.在九个肿瘤中，存在残留肿瘤。没有进行性疾病的病例。平均住院时间为一天。只有一个3级CTCAE事件发生,需要放置胸管的气胸。
结论：目前的研究证明IRE是HEHE的一种安全有效的微创治疗选择。
方法：在2017年至2023年之间，在23例手术中，使用CT扫描引导经皮IRE治疗了14例47例HEHE肿瘤患者。评估基线患者和肿瘤特征。主要结果指标包括安全性和有效性，使用不良事件通用术语标准(CTCAE)和mRECIST标准的治疗反应进行分析。次要结果指标包括技术成功，治疗后肿瘤大小和住院时间。技术成功定义为具有足够消融边缘的完全消融（有意无肿瘤消融边缘>5mm）。
结果：IRE治疗导致所有肿瘤的技术成功。经过15个月的中位随访，根据mRECIST标准,30个肿瘤显示完全响应。治疗前肿瘤平均大小为25.8mm,伴随着肿瘤大小平均减少7.5毫米。在47个肿瘤中，有38个，没有局部复发的证据.在九个肿瘤中，存在残留肿瘤。没有进行性疾病的病例。平均住院时间为一天。只有一个3级CTCAE事件发生,需要放置胸管的气胸。
结论：目前的研究证明IRE是HEHE的一种安全有效的微创治疗选择。
