Refractory malignant fibrous histiocytoma: CT-guided treatment with a multidisciplinary, minimally invasive approach

The purpose of this study is to evaluate the effectiveness and safety of a computed tomography (CT)-guided, multidisciplinary, minimally invasive approach to the treatment of patients with large, refractory malignant fibrous histiocytoma. This approach includes microwave ablation and absolute alcohol therapy combined with 125I seed implantation. Seven patients (5 males and 2 females, 26-78 years old, mean 49.7 years old) with large, refractory malignant fibrous histiocytoma participated in this study. The tumors had an average maximum diameter of 14.1 cm (10.0-19.0 cm). Follow-up was conducted for an average of 35.7 months to determine the local control rate, overall survival rate, and clinical complications. Follow-up times ranged from 2 to 45 months. Pain was significantly relieved in patients treated with multidisciplinary, minimally invasive approach. Complete response was achieved in 5 patients (71.4%), partial response in the other 2 patients (28.6%). The response rate of this treatment was 100%. The median survival time was 35.7 months. All patients were alive in 2 years after the treatment. Five patients were still alive after 3 years. The 3 year survival rate was 71.4%. The long-term complications included hyperpigmentation at the operative sites (n = 5) and insensible feeling at the ablation sites (n = 3).This CT-guided multidisciplinary, minimally invasive approach is an effective, safe, and feasible means of treating large, refractory malignant fibrous histiocytoma with minimal damage and few complications, but large-scale randomized clinical trials are necessary to confirm this assessment.