Abstract：
BACKGROUND: Image-guided therapies (IGTs) are commonly used in oncology, but their role in adrenocortical carcinoma (ACC) is not well defined.
METHODS: A retrospective review of patients with ACC treated with IGTs. We assessed response to therapy using RECIST v1.1, time to next line of systemic therapy, disease control rate (DCR), local tumor progression-free survival (LTPFS), and complications of IGTs (based on the Common Terminology Criteria for Adverse Events [CTCAE] version 5.0).
RESULTS: Our cohort included 26 patients (median age 56 years [range 38-76]; n = 18 female) who had 51 IGT sessions to treat 86 lesions. IGTs modalities included cryoablation (n = 49), microwave ablation (n = 21), combined microwave and bland trans-arterial embolization (n = 8), bland trans-arterial embolization alone (n = 3), radio-embolization (n = 3), and radiofrequency ablation (n = 2). DCR was 81.4% (70 out of 86), of which 66.3% of tumors showed complete response, 18.6% showed progressive disease, 8.1% showed partial response, and 7.0% showed stable disease. LTPFS rates were 73% and 63% at 1 and 2 years, respectively. Fourteen lesions underwent re-ablation for incomplete response on initial treatment. Sixteen patients (61.5%) received new systemic therapy following IGTs, with a median time to systemic therapy of 12.5 months (95% CI: 8.6 months upper limit not reached). There was 1 reported CTCAE grade 3 adverse event (biloma) following IGT.
CONCLUSIONS: IGT use in properly selected patients with ACC is safe and associated with prolonged disease control and delay in the need for systemic therapy.
METHODS: A retrospective review of patients with ACC treated with IGTs. We assessed response to therapy using RECIST v1.1, time to next line of systemic therapy, disease control rate (DCR), local tumor progression-free survival (LTPFS), and complications of IGTs (based on the Common Terminology Criteria for Adverse Events [CTCAE] version 5.0).
RESULTS: Our cohort included 26 patients (median age 56 years [range 38-76]; n = 18 female) who had 51 IGT sessions to treat 86 lesions. IGTs modalities included cryoablation (n = 49), microwave ablation (n = 21), combined microwave and bland trans-arterial embolization (n = 8), bland trans-arterial embolization alone (n = 3), radio-embolization (n = 3), and radiofrequency ablation (n = 2). DCR was 81.4% (70 out of 86), of which 66.3% of tumors showed complete response, 18.6% showed progressive disease, 8.1% showed partial response, and 7.0% showed stable disease. LTPFS rates were 73% and 63% at 1 and 2 years, respectively. Fourteen lesions underwent re-ablation for incomplete response on initial treatment. Sixteen patients (61.5%) received new systemic therapy following IGTs, with a median time to systemic therapy of 12.5 months (95% CI: 8.6 months upper limit not reached). There was 1 reported CTCAE grade 3 adverse event (biloma) following IGT.
CONCLUSIONS: IGT use in properly selected patients with ACC is safe and associated with prolonged disease control and delay in the need for systemic therapy.
摘要：
背景：图像引导疗法（IGT）通常用于肿瘤学，但它们在肾上腺皮质癌（ACC）中的作用尚不明确。
方法：对接受IGTs治疗的ACC患者进行回顾性分析。我们使用RECISTv1.1评估对治疗的反应，系统治疗的下一行时间，疾病控制率（DCR），局部肿瘤无进展生存期（LTPFS），和IGT的并发症（基于不良事件通用术语标准[CTCAE]5.0版）。
结果：我们的队列包括26名患者（中位年龄56岁[范围38-76]；n=18名女性），他们接受了51次IGT治疗86个病灶。IGTs模式包括冷冻消融(n=49)，微波消融（n=21），联合微波和平缓动脉栓塞（n=8），单用平淡的经动脉栓塞（n=3），放射栓塞（n=3），和射频消融（n=2）。DCR为81.4%(86人中有70人)，其中66.3%的肿瘤显示完全反应，18.6%表现为进行性疾病，8.1%显示部分反应，7.0%病情稳定。1年和2年的LTPFS率分别为73%和63%，分别。14个病变在初始治疗时由于反应不完全而接受了重新消融。16名患者（61.5%）在IGTs后接受了新的全身治疗，系统治疗的中位时间为12.5个月（95％CI：未达到8.6个月的上限）。IGT后有1例报告CTCAE3级不良事件(胆汁瘤)。
结论：在正确选择的ACC患者中使用IGT是安全的，并且与延长疾病控制和延迟全身治疗的需要相关。
方法：对接受IGTs治疗的ACC患者进行回顾性分析。我们使用RECISTv1.1评估对治疗的反应，系统治疗的下一行时间，疾病控制率（DCR），局部肿瘤无进展生存期（LTPFS），和IGT的并发症（基于不良事件通用术语标准[CTCAE]5.0版）。
结果：我们的队列包括26名患者（中位年龄56岁[范围38-76]；n=18名女性），他们接受了51次IGT治疗86个病灶。IGTs模式包括冷冻消融(n=49)，微波消融（n=21），联合微波和平缓动脉栓塞（n=8），单用平淡的经动脉栓塞（n=3），放射栓塞（n=3），和射频消融（n=2）。DCR为81.4%(86人中有70人)，其中66.3%的肿瘤显示完全反应，18.6%表现为进行性疾病，8.1%显示部分反应，7.0%病情稳定。1年和2年的LTPFS率分别为73%和63%，分别。14个病变在初始治疗时由于反应不完全而接受了重新消融。16名患者（61.5%）在IGTs后接受了新的全身治疗，系统治疗的中位时间为12.5个月（95％CI：未达到8.6个月的上限）。IGT后有1例报告CTCAE3级不良事件(胆汁瘤)。
结论：在正确选择的ACC患者中使用IGT是安全的，并且与延长疾病控制和延迟全身治疗的需要相关。
