Objectives: This single-center retrospective study evaluates the clinical efficacy and safety of percutaneous ablation using microwave ablation (MWA) and irreversible electroporation (IRE) in patients with breast cancer liver metastases (BCLM).Methods: Between August 2018 and December 2023, 32 patients underwent 40 image-guided ablations for 57 BCLM. Mean age was 61.3 years (range: 32–85), and mean tumor size was 2.9 cm (range: 0.9–7.0 cm). Fifty lesions were treated with MWA and seven with IRE. Clinical efficacy was assessed by m-RECIST response at first follow-up imaging (after ≥1 month) and by monitoring local tumor progression (LTP), local tumor progression-free survival (LTPFS), and overall survival (OS). Safety was evaluated by adverse events according to CTCAE. Kaplan–Meier statistics were used for LTPFS and OS.Results: Median follow-up was 32.4 months (95% CI 16.6–48.0). Complete response was observed in 34 tumors (59.6%), partial response in 14 (24.6%), and progressive disease in 9 (15.8%). LTP occurred in 37 tumors (64.9%), with a median time to progression of 11.1 months (95% CI 1.4–20.8). One- and two-year LTPFS rates were 43.6% and 34.1%. Sixteen patients died during follow-up, with median OS of 27.8 months (95% CI 19.0–36.6) and 1- and 2-year OS rates of 90.1% and 55.9%. No major complications occurred. Complications included eight Grade 1 and two Grade 2 complications.Conclusions: Percutaneous ablation demonstrates clinical efficacy and a favorable safety profile in selected BCLM patients, achieving OS comparable to the current literature. Further studies should clarify its additive role within multimodality treatment.
目的：本单中心回顾性研究旨在评估经皮微波消融（MWA）与不可逆电穿孔（IRE）治疗乳腺癌肝转移（BCLM）患者的临床疗效与安全性。 方法：2018年8月至2023年12月期间，共32例患者对57个BCLM病灶接受了40次影像引导消融治疗。患者平均年龄61.3岁（范围：32-85岁），平均肿瘤直径2.9 cm（范围：0.9-7.0 cm）。其中50个病灶采用MWA治疗，7个病灶采用IRE治疗。通过首次随访影像（≥1个月后）的m-RECIST标准评估临床疗效，并监测局部肿瘤进展（LTP）、局部无进展生存期（LTPFS）及总生存期（OS）。安全性依据CTCAE标准评估不良事件。采用Kaplan-Meier法分析LTPFS与OS。 结果：中位随访时间32.4个月（95% CI 16.6-48.0）。34个肿瘤（59.6%）达到完全缓解，14个（24.6%）部分缓解，9个（15.8%）疾病进展。37个肿瘤（64.9%）出现LTP，中位进展时间为11.1个月（95% CI 1.4-20.8）。1年及2年LTPFS率分别为43.6%和34.1%。随访期间16例患者死亡，中位OS为27.8个月（95% CI 19.0-36.6），1年及2年OS率分别为90.1%和55.9%。未发生严重并发症，共记录8例1级和2例2级并发症。 结论：经皮消融治疗在选择性BCLM患者中展现出临床疗效与良好的安全性，其OS数据与现有文献报道相当。未来研究需进一步明确该技术在多模态综合治疗中的协同作用。
Clinical Efficacy of Percutaneous Image-Guided Ablation in Breast Cancer Metastases to the Liver
肿瘤(癌症)患者之家