Treatment Of Retroperitoneal Tumors Research Articles

Clinical value of ultrasound-guided radiofrequency ablation in the treatment of retroperitoneal tumors

Objective: To explore the clinical value of ultrasound-guided radiofrequency ablation in the treatment of retroperitoneal tumors. Methods: The clinical data of 13 patients with retroperitoneal tumors treated with ultrasound-guided radiofrequency ablation in the First Affiliated Hospital of Zhengzhou University from January 2018 to January 2020 were analyzed retrospectively. The ablation effect was evaluated and the postoperative complications were observed. The changes of tumor volume before and after radiofrequency ablation were compared. Results: The symptoms of pain and dyspepsia were significantly improved after radiofrequency ablation, and the hospital stay was (9.2±2.9) days. The tumor was ablated completely in 10 cases, tumor residual in 1 case and tumor metastasis in 2 cases. One patient had postoperative duodenal perforation complicated with intra-abdominal infection, and no serious complications occurred in other patients. There were 20 lesions in 13 patients. The maximum diameter of 20 lesions before operation and 1, 3, 6 months after operation were (39.5±15.9) mm, (30.6±4.9)mm, (15.6±7.7) mm and (9.9±3.1) mm, respectively, the maximum diameters of 1, 3 and 6 months after operation were smaller than that before operation (P<0.05). Conclusion: Ultrasound-guided radiofrequency ablation is a real-time, accurate, safe and effective minimally invasive treatment with few complications, and has a high clinical value for retroperitoneal tumors.

Diagnosis and Treatment of Retroperitoneal Tumors

Diagnosis and Treatment of Retroperitoneal Tumors

Retroperitoneal tumors

Retroperitoneal tumors are rare malignancies. The retroperitoneum can host awide spectrum of pathologies including primary or metastatic lesions. Treatment of retroperitoneal tumors is often associated with several challenges because of their relative late presentation and anatomic location. Because of various pathologies, adetailed case history, laboratory investigation and ultrasound should be performed. Radiologic examinations remain amajor component in the diagnosis. In addition to computed tomography, magnetic resonance imaging and positron emission tomography are used. Although radiologic findings are often unspecific, there are often typical findings such as dissemination, margins, vascularization and tumor texture which contribute to the differential diagnosis even before making a definitive diagnosis. Due to the complexity of primary retroperitoneal tumors, which require different treatments depending on the final diagnosis, the treatment approach should be determined in a multidisciplinary tumor conference prior to histological confirmation and initiation of treatment. To ensure the best potential curative treatment modality for retroperitoneal tumors, treatment is best performed in high-volume centers by amultidisciplinary team.

Insulin-like growth factor-1 for amelioration and prevention of radiation-induced kidney dysfunction

9552 Purpose: To test whether insulin-like growth factor-1 (IGF-1) ameliorates or prevents radiation-induced kidney dysfunction and to establish the dose-effect relationship for this growth factor which has not previously been studied in conjunction with kidney irradiation. Background: The kidney is one of the most radiosensitive organs in the abdomen. Therefore, modification of its radiation response might improve the therapeutic ratio in the treatment of retroperitoneal tumors as well as gastric and other malignancies. Material and Methods: Adult female C3H mice were treated with single-fraction radiotherapy to the right kidney with doses of 10–17 Gy ± IGF-1. The kidney function was assessed prior to radiotherapy, 19 weeks thereafter and then every 6 weeks by means of 99mTc-DMSA scans, i.e. static scintigraphy. Maximum follow-up was 12 months. IGF-1 was given subcutaneously either concomitant to radiotherapy or after deterioration of the kidney function, i.e. after 5–6 months. At least 5 mice per group received concomitant IGF-1 starting 24h before irradiation for 3 days or 2 weeks. Delayed treatment after deterioration of the kidney function was administered over 4 weeks, immediately followed by repeat scans every 6 weeks. Doses of IGF-1 were 0.5–25 μg per injection. Results: The function of the irradiated kidney continuously declined during follow-up in all control groups in a dose-dependent fashion. Concomitant treatment with IGF-1 significantly reduced the number of mice with a severe decline, defined as loss of function of 50% or more. In contrast to controls, no statistically significant decline of the mean kidney function was observed in the best IGF-1 group. The best dose of IGF-1 was 5 μg per injection, administered over 2 weeks. Delayed treatment after deterioration of the kidney function was unable to restore the function regardless of the IGF-1 dose. Very few animals with delayed IGF-1 showed at least stabilisation of the compromised function. Conclusion: IGF-1 showed activity as a radioprotective agent when given concomitant to high-dose kidney irradiation. The optimum dose of IGF-1 was 5 μg per injection. In contrast, established renal insufficiency did not improve after IGF-1 treatment. No significant financial relationships to disclose.