Возможности мини- и неинвазивных методов термической деструкции в лечении больных агрессивным фиброматозом

Цель исследования – характеристика различных методов локальной физической деструкции, применяемых в лечении больных агрессивным фиброматозом, и демонстрация международного опыта их применения.

Материал и методы. Обзор отечественных и зарубежных научных источников, представленных в базах данных РИНЦ (Российский индекс научного цитирования) и NcBi (National center for Biotechnology information) в период с 2002 по 2022 г., посвященных особенностям методов термической аблации (таких как радиочастотная и микроволновая аблация, криодеструкция, высокоинтенсивная фокусированная ультразвуковая терапия), применяющихся в терапии пациентов с десмоидными фибромами различной локализации, их безопасности и эффективности.

Результаты. В обзоре представлены современные данные по безопасности и эффективности применения мини- и неинвазивных методов гипо- и гипертермической локальной деструкции у больных агрессивным фиброматозом, даны характеристики воздействия и указаны биологические эффекты при выполнении радиочастотной и микроволновой аблации, криодеструкции, высокоинтенсивной фокусированной ультразвуковой терапии, описаны основные ограничения методов, показания и противопоказания к их применению, а также используемые в клинической практике способы профилактики развития осложнений.

Заключение. Описанные способы локальной деструкции применяют в клинической практике в основном с паллиативной и симптоматической целью, при упорном росте или рецидивировании опухоли, неэффективности других вариантов лечения или наличии противопоказаний к ним со стороны сопутствующей соматической патологии или функционального статуса пациента. Включение рассмотренных методов в план лечения больных агрессивным фиброматозом может способствовать снижению болевого синдрома, улучшению функционального статуса пациентов, а также достижению длительного периода жизни без прогрессирования опухолевого процесса.

1. Martínez Trufero J., Pajares Bernad I., Torres Ramón I., Hernando Cubero J., Pazo Cid R. Desmoid-Type Fibromatosis: Who, When, and How to Treat. Curr Treat Options Oncol. 2017; 18(5): 29. doi: 10.1007/s11864-017-0474-0.

2. Kasper B. The EORTC QLQ-C30 Summary Score as a Prognostic Factor for Survival of Patients with Cancer: A Commentary. Oncologist. 2020; 25(4): 610–1. doi: 10.1634/theoncologist.2019-0749.

3. van Broekhoven D.L., Grünhagen D.J., den Bakker M.A., van Dalen T., Verhoef C. Time trends in the incidence and treatment of extra-abdominal and abdominal aggressive fibromatosis: a population-based study. Ann Surg Oncol. 2015; 22(9): 2817–23. doi: 10.1245/s10434-015-4632-y.

4. Li Destri G., Ferraro M.J., Calabrini M., Pennisi M., Magro G. Desmoid-type fibromatosis of the mesentery: report of a sporadic case with emphasis on differential diagnostic problems. Case Rep Med. 2014. doi: 10.1155/2014/850180.

5. Alman B., Attia S., Baumgarten C., et al. Desmoid Tumor Working Group. The management of desmoid tumours: A joint global consensusbased guideline approach for adult and paediatric patients. Eur J Cancer. 2020; 127: 96–107. https://doi.org/10.1016/j.ejca.2019.11.013.

6. Koskenvuo L., Ristimäki A., Lepistö A. Comparison of sporadic and FAP-associated desmoid-type fibromatoses. J Surg Oncol. 2017; 116(6): 716–21. doi: 10.1002/jso.24699.

7. Sanchez-Mete L., Ferraresi V., Caterino M., Martayan A., Terrenato I., Mannisi E., Stigliano V. Desmoid Tumors Characteristics, Clinical Management, Active Surveillance, and Description of Our FAP Case Series. J Clin Med. 2020; 9(12): 4012. doi: 10.3390/jcm9124012.

8. Crago A.M., Chmielecki J., Rosenberg M., O’Connor R., Byrne C., Wilder F.G., Thorn K., Agius P., Kuk D., Socci N.D., Qin L.X., Meyerson M., Hameed M., Singer S. Near universal detection of alterations in CTNNB1 and Wnt pathway regulators in desmoid-type fibromatosis by whole-exome sequencing and genomic analysis. Genes Chromosomes Cancer. 2015; 54(10): 606–15. doi: 10.1002/gcc.22272.

9. Skubitz K.M. Biology and Treatment of Aggressive Fibromatosis or Desmoid Tumor. Mayo Clin Proc. 2017; 92(6): 947–64. doi: 10.1016/j.mayocp.2017.02.012.

10. Kasper B., Baumgarten C., Garcia J., Bonvalot S., Haas R., Haller F., Hohenberger P., Penel N., Messiou C., van der Graaf W.T., Gronchi A.; Desmoid Working Group. An update on the management of sporadic desmoid-type fibromatosis: a European Consensus Initiative between Sarcoma PAtients EuroNet (SPAEN) and European Organization for Research and Treatment of Cancer (EORTC)/Soft Tissue and Bone Sarcoma Group (STBSG). Ann Oncol. 2017; 28(10): 2399–408. doi: 10.1093/annonc/mdx323.

11. Penel N., Le Cesne A., Bonvalot S., Giraud A., Bompas E., Rios M., Salas S., Isambert N., Boudou-Rouquette P., Honore C., Italiano A., RayCoquard I., Piperno-Neumann S., Gouin F., Bertucci F., Ryckewaert T., Kurtz J.E., Ducimetiere F., Coindre J.M., Blay J.Y. Surgical versus nonsurgical approach in primary desmoid-type fibromatosis patients: A nationwide prospective cohort from the French Sarcoma Group. Eur J Cancer. 2017; 83: 125–31. doi: 10.1016/j.ejca.2017.06.017.

12. Choi S.H., Yoon H.I., Kim S.H., Kim S.K., Shin K.H., Suh C.O. Optimal radiotherapy strategy for primary or recurrent fibromatosis and long-term results. PLoS One. 2018; 13(5). doi: 10.1371/journal.pone.0198134.

13. Janssen M.L., van Broekhoven D.L., Cates J.M., Bramer W.M., Nuyttens J.J., Gronchi A., Salas S., Bonvalot S., Grünhagen D.J., Verhoef C. Meta-analysis of the influence of surgical margin and adjuvant radiotherapy on local recurrence after resection of sporadic desmoid-type fibromatosis. Br J Surg. 2017; 104(4): 347–57. doi: 10.1002/bjs.10477.

14. Bishop A.J., Zarzour M.A., Ratan R., Torres K.E., Feig B.W., Wang W.L., Lazar A.J., Moon B.S., Roland C.L., Guadagnolo B.A. LongTerm Outcomes for Patients With Desmoid Fibromatosis Treated With Radiation Therapy: A 10-Year Update and Re-evaluation of the Role of Radiation Therapy for Younger Patients. Int J Radiat Oncol Biol Phys. 2019; 103(5): 1167–74. doi: 10.1016/j.ijrobp.2018.12.012.

15. Bishop A.J., Landry J.P., Roland C.L., Ratan R., Feig B.W., Moon B.S., Zarzour M.A., Wang W.L., Lazar A.J., Lewis V.O., Torres K.E., Guadagnolo B.A. Certain risk factors for patients with desmoid tumors warrant reconsideration of local therapy strategies. Cancer. 2020; 126(14): 3265–73. doi: 10.1002/cncr.32921.

16. Gronchi A., Colombo C., Le Péchoux C., Dei Tos A.P., Le Cesne A., Marrari A., Penel N., Grignani G., Blay J.Y., Casali P.G., Stoeckle E., Gherlinzoni F., Meeus P., Mussi C., Gouin F., Duffaud F., Fiore M., Bonvalot S.; ISG and FSG. Sporadic desmoid-type fibromatosis: a stepwise approach to a non-metastasising neoplasm--a position paper from the Italian and the French Sarcoma Group. Ann Oncol. 2014; 25(3): 578–83. doi: 10.1093/annonc/mdt485.

17. Болотина Л.В., Новикова О.В., Прокофьева Е.А. Роль химиотерапии в лечении агрессивного фиброматоза. Онкология. Журнал им. П.А. Герцена. 2012; 1(3): 72–6.

18. Palassini E., Frezza A.M., Mariani L., Lalli L., Colombo C., Fiore M., Messina A., Casale A., Morosi C., Collini P., Stacchiotti S., Casali P.G., Gronchi A. Long-term Efficacy of Methotrexate Plus Vinblastine/Vinorelbine in a Large Series of Patients Affected by Desmoid-Type Fibromatosis. Cancer J. 2017; 23(2): 86–91. doi: 10.1097/PPO.0000000000000254.

19. Toulmonde M., Pulido M., Ray-Coquard I., Andre T., Isambert N., Chevreau C., Penel N., Bompas E., Saada E., Bertucci F., Lebbe C., Le Cesne A., Soulie P., Piperno-Neumann S., Sweet S., Cecchi F., Hembrough T., Bellera C., Kind M., Crombe A., Lucchesi C., Le Loarer F., Blay J.Y., Italiano A. Pazopanib or methotrexate-vinblastine combination chemotherapy in adult patients with progressive desmoid tumours (DESMOPAZ): a non-comparative, randomised, open-label, multicentre, phase 2 study. Lancet Oncol. 2019; 20(9): 1263–72. doi: 10.1016/S14702045(19)30276-1.

20. Kummar S., O’Sullivan Coyne G., Do K.T., Turkbey B., Meltzer P.S., Polley E., Choyke P.L., Meehan R., Vilimas R., Horneffer Y., Juwara L., Lih A., Choudhary A., Mitchell S.A., Helman L.J., Doroshow J.H., Chen A.P. Clinical Activity of the γ-Secretase Inhibitor PF-03084014 in Adults With Desmoid Tumors (Aggressive Fibromatosis). J Clin Oncol. 2017; 35(14): 1561–9. doi: 10.1200/JCO.2016.71.1994.

21. Gounder M.M., Mahoney M.R., Van Tine B.A., Ravi V., Attia S., Deshpande H.A., Gupta A.A., Milhem M.M., Conry R.M., Movva S., Pishvaian M.J., Riedel R.F., Sabagh T., Tap W.D., Horvat N., Basch E., Schwartz L.H., Maki R.G., Agaram N.P., Lefkowitz R.A., Mazaheri Y., Yamashita R., Wright J.J., Dueck A.C., Schwartz G.K. Sorafenib for Advanced and Refractory Desmoid Tumors. N Engl J Med. 2018; 379(25): 2417–28. doi: 10.1056/NEJMoa1805052.

22. Testa S., Bui N.Q., Charville G.W., Avedian R.S., Steffner R., Ghanouni P., Mohler D.G., Ganjoo K.N. Management of Patients with Newly Diagnosed Desmoid Tumors in a First-Line Setting. Cancers (Basel). 2022; 14(16): 3907. doi: 10.3390/cancers14163907.

23. Mikhael R., Smith M., Tzanis D., Watson S., Miah A.B., Bonvalot S. Desmoid tumors: who, when and how to treat? Curr Opin Oncol. 2022; 34(4): 335–41. doi: 10.1097/CCO.0000000000000854.

24. Zhou M.Y., Bui N.Q., Charville G.W., Ghanouni P., Ganjoo K.N. Current management and recent progress in desmoid tumors. Cancer Treat Res Commun. 2022; 31. doi: 10.1016/j.ctarc.2022.100562.

25. Москвичева Л.И., Сидоров Д.В., Ложкин М.В., Петров Л.О., Забелин М.В. Современные методы абляции злокачественных новообразований печени. Research and Practical Medicine Journal. 2018; 5(4): 58–71. doi: 10.17709/2409-2231-2018-5-4-6.

26. Москвичева Л.И., Петров Л.О., Сидоров Д.В. Возможности современных методов абляции при нерезектабельном местнораспространенном раке поджелудочной железы. Research and Practical Medicine Journal. 2018; 5(2): 86–99. doi: 10.17709/24092231-2018-5-2-10.

27. Hinshaw J.L., Lubner M.G., Ziemlewicz T.J., Lee F.T., Brace C.L. Percutaneous tumor ablation tools: microwave, radiofrequency, or cryoablation – what should you use and why? Radiographics. 2014; 34(5): 1344–62. doi: 10.1148/rg.345140054.

28. Zhang Z., Shi J., Yang T., Liu T., Zhang K. Management of aggressive fibromatosis. Oncol Lett. 2021; 21(1): 43. doi: 10.3892/ol.2020.12304.

29. Tsz-Kan T., Man-Kwong C., Shu Shang-Jen J., Ying-Lee L., Wai Man-Wah A., Hon-Shing F. Radiofrequency ablation of recurrent fibromatosis. J Vasc Interv Radiol. 2007; 18(1 Pt 1): 147–50. doi: 10.1016/j.jvir.2006.08.001.

30. Ilaslan H., Schils J., Joyce M., Marks K., Sundaram M. Radiofrequency ablation: another treatment option for local control of desmoid tumors. Skeletal Radiol. 2010; 39(2): 169–73. doi: 10.1007/s00256-009-0807-6.

31. Barrow E., Newton K., Rajashanker B., Lee S., Evans D.G., Hill J. Successful radiofrequency ablation of an anterior abdominal wall desmoid in familial adenomatous polyposis. Colorectal Dis. 2013; 15(3): 160–3. doi: 10.1111/codi.12064.

32. Wang L., Xu D., Chen L., Huang P. Percutaneous ultrasound-guided radiofrequency ablation for giant desmoid tumors of the intra-abdominal cavity in a patient with Gardner syndrome. J Cancer Res Ther. 2021; 17: 1286–8. doi: 10.4103/jCRT.jCRT_316_21.

33. Cobianchi L., Ravetta V., Viera F.T., Filisetti C., Siri B., Segalini E., Maestri M., Dominioni T., Alessiani M., Rossi S., Dionigi P. The challenge of extraabdominal desmoid tumour management in patients with Gardner’s syndrome: radiofrequency ablation, a promising option. World J Surg Oncol. 2014; 12: 361. doi: 10.1186/1477-7819-12-361.

34. Lubner M.G., Brace C.L., Hinshaw J.L., Lee F.T. Microwave tumor ablation: mechanism of action, clinical results, and devices. J Vasc Interv Radiol. 2010; 21 (8s): 192–203. doi: 10.1016/j.jvir.2010.04.007.

35. Facciorusso A., Di Maso M., Muscatiello N. Microwave ablation versus radiofrequency ablation for the treatment of hepatocellular carcinoma: A systematic review and meta-analysis. Int J Hyperthermia. 2016; 32(3): 339–44. doi: 10.3109/02656736.2015.1127434.

36. Sun Y., Cheng Z., Dong L., Zhang G., Wang Y., Liang P. Comparison of temperature curve and ablation zone between 915- and 2450-MHz cooled-shaft microwave antenna: results in ex vivo porcine livers. Eur J Radiol. 2012; 81(3): 553–7. doi: 10.1016/j.ejrad.2011.02.013.

37. Yu N.C., Lu D.S., Raman S.S., Dupuy D.E., Simon C.J., Lassman C., Aswad B.I., Ianniti D., Busuttil R.W. Hepatocellular carcinoma: microwave ablation with multiple straight and loop antenna clusters--pilot comparison with pathologic findings. Radiology. 2006; 239(1): 269–75. doi: 10.1148/radiol.2383041592.

38. Sainani N.I., Gervais D.A., Mueller P.R., Arellano R.S. Imaging after percutaneous radiofrequency ablation of hepatic tumors: Part 1, Normal findings. Am J Roentgenol. 2013; 200(1): 184–93. doi: 10.2214/AJR.12.8478.

39. Vogl T.J., Nour-Eldin N.A., Hammerstingl R.M., Panahi B., Naguib N.N.N. Microwave Ablation (MWA): Basics, Technique and Results in Primary and Metastatic Liver Neoplasms – Review Article. Rofo. 2017; 189(11): 1055–66. doi: 10.1055/s-0043-117410.

40. Martínez-Martínez A., García-Espinosa J., Láinez Ramos-Bossini A.J., Ruiz Santiago F. Percutaneous Microwave Ablation of Desmoid Fibromatosis. Korean J Radiol. 2021; 22(6): 944–50. doi: 10.3348/kjr.2020.0768.

41. Goldberg D., Woodhead G., Hannallah J., Young S. Role of the Interventional Radiologist in the Treatment of Desmoid Tumors. Life (Basel). 2023; 13(3): 645. https://doi.org/10.3390/life13030645.

42. Hoffmann N.E., Bischof J.C. The cryobiology of cryosurgical injury. Urology. 2002; 60(2s1): 40–9. doi: 10.1016/s0090-4295(02)01683-7.

43. Gage A.A., Guest K., Montes M., Caruana J.A., Whalen D.A. Effect of varying freezing and thawing rates in experimental cryosurgery. Cryobiology. 1985; 22(2): 175–82. doi: 10.1016/0011-2240(85)90172-5.

44. Mahnken A.H., König A.M., Figiel J.H. Current Technique and Application of Percutaneous Cryotherapy. Rofo. 2018; 190(9): 836–46. doi: 10.1055/a-0598-5134.

45. Seifert J.K., Morris D.L. World survey on the complications of hepatic and prostate cryotherapy. World J Surg. 1999; 23(2): 109–13; discussion 113–4. doi: 10.1007/pl00013173.

46. Vora B.M.K., Munk P.L., Somasundaram N., Ouellette H.A., Mallinson P.I., Sheikh A., Abdul Kadir H., Tan T.J., Yan Y.Y. Cryotherapy in extra-abdominal desmoid tumors: A systematic review and meta-analysis. PLoS One. 2021; 16(12). doi: 10.1371/journal.pone.0261657.

47. Cazzato R.L., Gantzer J., de Marini P., Garnon J., Koch G., Buy X., Autrusseau P.A., Auloge P., Dalili D., Kurtz J.E., Gangi A. Sporadic Desmoid Tumours: Systematic Review with Reflection on the Role of Cryoablation. Cardiovasc Intervent Radiol. 2022; 45(5): 613–21. doi: 10.1007/s00270-022-03091-5.

48. Efrima B., Ovadia J., Drukman I., Khoury A., Rath E., Dadia S., Gortzak Y., Albagli A., Sternheim A., Segal O. Cryo-surgery for symptomatic extra-abdominal desmoids. A proof of concept study. J Surg Oncol. 2021; 124(4): 627–34. doi: 10.1002/jso.26528.

49. Auloge P., Garnon J., Robinson J.M., Thenint M.A., Koch G., Caudrelier J., Weiss J., Cazzato R.L., Kurtz J.E., Gangi A. Percutaneous cryoablation for advanced and refractory extra-abdominal desmoidtumors. Int J Clin Oncol. 2021; 26(6): 1147–58. doi: 10.1007/s10147021-01887-y.

50. Saltiel S., Bize P.E., Goetti P., Gallusser N., Cherix S., Denys A., Becce F., Tsoumakidou G. Cryoablation of Extra-Abdominal Desmoid Tumors: A Single-Center Experience with Literature Review. Diagnostics (Basel). 2020; 10(8): 556. doi: 10.3390/diagnostics10080556.

51. Schmitz J.J., Schmit G.D., Atwell T.D., Callstrom M.R., Kurup A.N., Weisbrod A.J., Morris J.M. Percutaneous Cryoablation of Extraabdominal Desmoid Tumors: A 10-Year Experience. Am J Roentgenol. 2016; 207(1): 190–5. doi: 10.2214/AJR.15.14391.

52. Redifer Tremblay K., Lea W.B., Neilson J.C., King D.M., Tutton S.M. Percutaneous cryoablation for the treatment of extra-abdominal desmoid tumors. J Surg Oncol. 2019; 120(3): 366–75. doi: 10.1002/jso.25597.

53. Bouhamama A., Lame F., Mastier C., Cuinet M., Thibaut A., Beji H., Ricoeur A., Blay J.Y., Pilleul F. Local Control and Analgesic Efficacy of Percutaneous Cryoablation for Desmoid Tumors. Cardiovasc Intervent Radiol. 2020; 43(1): 110–9. doi: 10.1007/s00270-019-02323-5.

54. Kurtz J.E., Buy X., Deschamps F., Sauleau E., Bouhamama A., Toulmonde M., Honoré C., Bertucci F., Brahmi M., Chevreau C., Duffaud F., Gantzer J., Garnon J., Blay J.Y., Gangi A. CRYODESMO-O1: A prospective, open phase II study of cryoablation in desmoid tumour patients progressing after medical treatment. Eur J Cancer. 2021; 143: 78–87. doi: 10.1016/j.ejca.2020.10.035.

55. Mandel J.E., Kim D., Yarmohammadi H., Ziv E., Keohan M.L., D’Angelo S.P., Gounder M.M., Whiting K., Qin L.X., Singer S., Crago A.M., Erinjeri J.P. Percutaneous Cryoablation Provides Disease Control for Extra-Abdominal Desmoid-Type Fibromatosis Comparable with Surgical Resection. Ann Surg Oncol. 2022; 29(1): 640–8. doi: 10.1245/s10434021-10463-7.

56. Izadifar Z., Izadifar Z., Chapman D., Babyn P. An Introduction to High Intensity Focused Ultrasound: Systematic Review on Principles, Devices, and Clinical Applications. J Clin Med. 2020; 9(2): 460. doi: 10.3390/jcm9020460.

57. Москвичева Л.И. Высокоинтенсивная фокусированная ультразвуковая абляция злокачественных новообразований молочной железы. Research and Practical Medicine Journal. 2018; 5(3): 67–76. doi: 10.17709/2409-2231-2018-5-3-6.

58. Siedek F., Yeo S.Y., Heijman E., Grinstein O., Bratke G., Heneweer C., Puesken M., Persigehl T., Maintz D., Grüll H. Magnetic Resonance-Guided High-Intensity Focused Ultrasound (MR-HIFU): Technical Background and Overview of Current Clinical Applications (Part 1). Rofo. 2019; 191(6): 522–30. doi: 10.1055/a-0817-5645.

59. Elhelf I.A.S., Albahar H., Shah U., Oto A., Cressman E., Almekkawy M. High intensity focused ultrasound: The fundamentals, clinical applications and research trends. Diagn Interv Imaging. 2018; 99(6): 349–59. doi: 10.1016/j.dIII.2018.03.001.

60. Болотина Л.В., Москвичева Л.И., Корниецкая А.Л., Сидоров Д.В., Гришин Н.А., Ложкин М.В., Каприн А.Д. Предварительная оценка эффективности комбинированного лечения с включением HIFUтерапии у больных раком поджелудочной железы. Сибирский онкологический журнал. 2021; 20(3): 18–27. doi: 10.21294/1814-4861-2021-20-3-18-27.

61. Москвичева Л.И. Применение HIFU-терапии в онкологии (2000–2021 гг.). Онкология. Журнал им. П.А. Герцена. 2022; 11(1): 64–74. doi: 10.17116/onkolog20221101164.

62. Wang Y., Wang W., Tang J. Ultrasound-guided high intensity focused ultrasound treatment for extra-abdominal desmoid tumours: preliminary results. Int J Hyperthermia. 2011; 27(7): 648–53. doi: 10.3109/02656736.2011.597047.

63. Zhao W.P., Han Z.Y., Zhang J., Yu X.L., Cheng Z.G., Zhou X., Liang P. Early experience: high-intensity focused ultrasound treatment for intra-abdominal aggressive fibromatosis of failure in surgery. Br J Radiol. 2016; 89(1062). doi: 10.1259/bjr.20151026.

64. Zhang R., Chen J.Y., Zhang L., Li K.Q., Xiao Z.B., Mo S.J., Chen L., Chen W.Z. The safety and ablation efficacy of ultrasound-guided high-intensity focused ultrasound ablation for desmoid tumors. Int J Hyperthermia. 2021; 38(2): 89–95. doi: 10.1080/02656736.2021.1894359.

65. Zhong X., Hu X., Zhao P., Wang Y., Fang X.F., Shen J., Shen H., Yuan Y. The efficacy of low-power cumulative high-intensity focused ultrasound treatment for recurrent desmoid tumor. Cancer Med. 2022; 11(10): 2079–84. doi: 10.1002/cam4.4573.

66. Yang Y., Zhang J., Pan Y. Management of unresectable and recurrent intra-abdominal desmoid tumors treated with ultrasound-guided highintensity focused ultrasound: A retrospective single-center study. Medicine (Baltimore). 2022; 101(34). doi: 10.1097/MD.0000000000030201.

67. Ghanouni P., Dobrotwir A., Bazzocchi A., Bucknor M., Bitton R., Rosenberg J., Telischak K., Busacca M., Ferrari S., Albisinni U., Walters S., Gold G., Ganjoo K., Napoli A., Pauly K.B., Avedian R. Magnetic resonanceguided focused ultrasound treatment of extra-abdominal desmoid tumors: a retrospective multicenter study. Eur Radiol. 2017; 27(2): 732–40. doi: 10.1007/s00330-016-4376-5.

68. NajAFI A., Fuchs B., Binkert C.A. Mid-term results of MR-guided high-intensity focused ultrasound treatment for relapsing superficial desmoids. Int J Hyperthermia. 2019; 36(1): 538–42.