58 - Safety and Efficacy of Cryoablation and Transarterial Chemoembolization of Desmoid Tumors

Cryoablation and transarterial chemoembolization (TACE) using drug-eluting beads have been used to treat desmoid tumor (DT). Combinational therapy of these two methods is not well documented in the medical literature. This study analyzes desmoid tumor volume, post treatment enhancement, and pain level after combinations of these two therapies.


Materials and Methods:

This retrospective chart review includes patients receiving combination of cryoablation and TACE for treatment of desmoid tumors from 9/1/2017 to 9/25/24. Total number and specific order of treatments was determined by the interventional radiologist.  8 patients (6 females, 2 males) met the inclusion criteria. Average age at time of first treatment was 35.5 years. Treatment response was assessed by MRI and CT to monitor tumor volume (ml) and tumor enhancement (PACS-derived pixel measurement) up to two years post treatment. Pain index score (0 to 10) was found from chart review during same time intervals post treatment.



Results:

All procedures were successful without immediate complications. The average size of DT prior to treatment was 233.6 ml (range 32.2 – 453.9 ml). By 3 months post treatment, 6/8 tumors (75%) exhibited volume reduction (mean:  –11.0%). The two patients with increased DT volume were recommended to pursue further ablation treatment but declined as their pain had been reduced. At 6 months, average tumor reduction was –41.9% and average pain reduction was –50.4%. At 12 months, average tumor reduction was –51.5% and average pain reduction was –55.2%. At 24 months, average tumor reduction was –51.8% (p = 0.28), average tumor enhancement reduction was –53.9% (p = 0.15) and average pain reduction was –51.6% (p = 0.07). One patient was lost to follow up at 6 months, and one patient has thus far only completed 3 months of post treatment.

Initial treatment with TACE followed by cryoablation resulted in 24-month DT volume regression of –78.4%, compared to –25.2% with an initial treatment with cryoablation.



Conclusion:

Cryoablation and TACE can be used to treat DT to reduce pain and volume. Treatment with TACE prior to cryoablation might be a more effective treatment method but a larger sample size is required to establish significance. This study is limited by a lack of statistical power, but the low p-values even with a small sample size establish an intriguing trend that warrants further research regarding the sequence of treatments.