Reiterative Radiofrequency Ablation in the Management of Pediatric Patients with Hepatoblastoma Metastases to the Lung, Liver, or Bone

Journal Article · Tue Jan 15 04:00:00 EST 2019 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-018-2097-7· OSTI ID:22953166

Yevich, Steven; Calandri, Marco; Gravel, Guillaume ^[1]; Fresneau, Brice; Brugières, Laurence; Valteau-Couanet, Dominique ^[2]; Branchereau, Sophie ^[3]; Chardot, Christophe ^[4]; Aerts, Isabelle ^[5]; Baere, Thierry de; Tselikas, Lambros; Deschamps, Frederic ^[1]

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1. Gustave Roussy, Interventional Radiology Department (France)
2. Gustave Roussy, Pediatric and Teenage Oncology Department (France)
3. Hospital du Kremlin Bicêtre, Pediatric Surgery Department (France)
4. Hospital Necker enfants malades, Pediatric Surgery Department (France)
5. Institut Curie, Pediatric and Teenage Oncology Department (France)

Background and Purpose: Conventional treatments of systemic chemotherapy and surgical resection for recurrent or metastatic hepatoblastoma (HB) may be inhibitive for the pediatric patient and family who have already been through extensive therapies. This single-institution case series evaluates the safety and efficacy of percutaneous radiofrequency ablation (RFA) in the management of metastatic HB. Materials and Methods: Between March 2008 and February 2015, RFA was used as part of multidisciplinary management for HB recurrence or metastasis in 5 children (median 5.0 years old) in an attempt to provide locoregional control and preclude additional surgery. Combined local treatments of 38 metachronous metastases included surgical metastasectomy (14 lesions: 7 lung, 7 liver), percutaneous RFA (23 lesions: 21 lung, 1 liver, 1 bone), and stereotactic radiotherapy (1 liver lesion). Results: For lesions treated with RFA (median diameter 6 mm, range 3–15 mm), local control was achieved in 22/23 metastases (95.6%) with median follow-up of 30.1 months after RFA (range 18.9–65.7). Median hospitalization was 3 days (2–7), with major complications limited to 1 pneumothorax requiring temporary small-caliber chest tube. Four children remain in complete remission with median follow-up of 67 months (range 41.2–88.8) after primary tumor resection, with mean disease-free survival of 31.7 months after last local treatment. One child succumbed to rapidly progressive disease 12 months after RFA (23.9 months after primary tumor resection). Conclusion: RFA provides a safe and effective reiterative treatment option in the multidisciplinary management of children with metastatic HB.

• OSTI ID: 22953166
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 1 Vol. 42; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

61 RADIATION PROTECTION AND DOSIMETRY
62 RADIOLOGY AND NUCLEAR MEDICINE
CHEMOTHERAPY
CHILDREN
LIVER
LUNGS
METASTASES
NEOPLASMS
PATIENTS
PEDIATRICS
RADIOTHERAPY
RF SYSTEMS
SKELETON