Phase I study of percutaneous cryotherapy for colorectal liver metastasis.
Huang A, McCall JM, Weston MD, Mathur P, Quinn H,
Henderson DC, Allen-Mersh TG.
Department of Surgery, Faculty
of Medicine, Imperial College of Science, Technology and Medicine,
Chelsea, UK. email@example.com
BACKGROUND: The aim was to determine the safety
and feasibility of percutaneous cryotherapy for treating irresectable
colorectal liver metastases. METHODS: Liquid nitrogen cryoprobes
were inserted percutaneously into metastases using the Seldinger
technique under computed tomographic guidance. Single-probe treatments
were performed with either 3.6- or 6.3-mm cryoprobes (ice-ball volumes
18 and 59 cm3 respectively), or dual-probe treatments with two adjacent
6.3-mm probes (ice-ball volume 205 cm3). Treatment involved a single
freeze--thaw cycle. RESULTS: Fifteen patients received 25 single-probe
treatments and seven patients received 14 dual-probe treatments.
The treatment-related mortality rate was zero and complications
occurred after six of 39 treatments. Liver metastasis growth was
significantly delayed for 2 months after dual-probe but not single-probe
treatment. Metastasis cryotherapy stimulated an immediate rise,
followed by a fall, in serum carcinoembryonic antigen (CEA) level,
associated with immune upregulation that was significantly greater
after dual-probe treatments. CONCLUSION: Ablation zones that were
approximately four times larger than those produced by previously
described percutaneous techniques delayed the growth of metastases,
reduced serum CEA concentration, and induced detectable inflammatory
and T-lymphocyte responses. Percutaneous cryotherapy for treatment
of colorectal liver metastases is feasible and may have a place
in conjunction with chemotherapy.
· Clinical Trial
· Clinical Trial, Phase I
PMID: 11872054 [PubMed - indexed for MEDLINE]