Effect of pre-treatment with gonadotropin-releasing hormone analogue GnRH-α on high-intensity focussed ultrasound ablation for diffuse adenomyosis: a preliminary study

Zhang Xiao-Ying, Xiao-Ying Z, Guo Ying-Shu, Ying-Shu G, Chen Jiu-Mei, Jiu-Mei C, Jin-Juan W, Wang Jin-Juan, Jinjuan Wang, Hong Y, Ye Hong, Hong Ye, Zang Chun-Yi, Chunyi Zang, Chun-Yi Z, Hua D, Duan Hua, Hua Duan
International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group · 2018 · vol. 34(8) , pp. 1289–1297 · doi:10.1080/02656736.2018.1440014 · PMID:29447020 · W2791802622
article OA: bronze CC0 ⤵ 11 in-corpus citations
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GnRH-α pre-treatment followed by HIFU ablation for diffuse adenomyosis showed increased non-perfusion volume and better pain relief at 6-12 months compared to HIFU alone, with no increase in adverse effects.

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Abstract

OBJECTIVES: To evaluate the efficacy and safety of GnRH-α pre-treatment with HIFU ablation for diffuse adenomyosis. METHODS: From January 2014 to December 2016, 61 patients were divided into two groups. Twenty-three patients with larger uteri received pre-treatment with GnRH-α and were then subjected to HIFU, and 38 patients underwent HIFU alone. The technical parameters included treatment time, sonication time, average sonication power, treatment intensity, total energy, non-perfusion volume (NPV) and NPV ratio. Intra-, post-procedural complaints, the relief rate of dysmenorrhoea and clinical effectiveness were followed up. RESULTS: Although the lesion volume in the HIFU + GnRH group was larger than in the HIFU-only group, higher NPV, NPVR%, treatment intensity and total energy with shorter treatment and sonication times in the HIFU + GnRH group were obtained than that in the HIFU-only group. Significant differences were evident for NPV, NPVR%, average power, and total intensity energy (p 0.05). Although no differences in the intra-, post-procedural VAS scores, in the adverse effects and in the relief rate or clinical effectiveness were apparent between the two groups (p > 0.05), the relief rate was better in the HIFU + GnRH group than that in the HIFU group from 6 to 12 months after treatment. Self-comparison of differences occurred in the two groups before and after treatment (p < 0.05) and were between the two groups after only 6 months (p < 0.05). CONCLUSION: The combination of HIFU with GnRH-α is more effective than HIFU alone for ablation of diffuse adenomyosis. Moreover, the GnRH-α pre-treatment with HIFU is safe.

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Condition tags

adenomyosisdysmenorrhea

MeSH descriptors

Adenomyosis Adenomyosis Gonadotropin-Releasing Hormone High-Intensity Focused Ultrasound Ablation Adenomyosis Adult Combined Modality Therapy Female Gonadotropin-Releasing Hormone Humans Middle Aged Uterus Uterus Uterus Uterus

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