Efficacy of percutaneous chemoablation of malignant metastatic lymph nodes

Abstract

Objective To investigate the technique,safety and efficacy of percutaneous chemoablation of single and multiple confluent metastatic lymphatic nodes (LNs). Methods Forty six patients of malignant metastatic LNs were treated with percutaneous chemoablation with CT guidance,and they were divided into two groups,including 30 patients of single isolated metastatic LN (group A) and 16 patients of multiple and/or confluent metastatic LNs (group B).A mixture of 5 ml absolute ethyl alcohol,2 ml iodized oil and 10 mg epirubicin was injected into the lymph node (s).The average tumor diameter was (2.0±0.5) cm in group A and (3.8±0.6) cm in group B.The intratumoral drug coverage rate and the occurrence of reflux were recorded.Enhanced CT scans were performed to observe the therapeutic effects at the intervals of 3,6 and 12 months. Results The coverage rate was 100% in group A,which was significantly higher than group B (70% to 80%).The occurrence of reflux was 70% for group A versus 40% for group B.For group A,a complete response (CR) patients of 14,21,28 and a partial response (PR) patients of 16,9,2 were obtained at 3,6 and 12 months after therapy respectively.For group B,a CR patient of 0,0,0 and PR patients of 3,8,9 were observed at 3,6 and 12 months after therapy respectively.Standardized rate by direct method was performed and the CR rate (74.4%) for group A was higher than that for group B (0) (P=0.0001).The tumor FDG uptake was lower compared with the preoperative images.No serious complications were observed.A few patients had mild pain during the procedure,which was relieved after 2.0 to 3.0 ml of 2% lidocaine injection adjacent to the tumor.No needle tract seeding or infection were observed.There was no effect on patients' overall survival. Conclusions CT-guided chemoablation is an effective,low-cost and minimally invasive procedure,which is better for treating single metastatic LN than multiple and/or confluent ones. Key words: Lymph nodes; Neoplasm metastasis; Radiology,interventional