Comparison between radiofrequency ablation combined with mifepristone and radiofrequency ablation for large uterine fibroids

Abstract

Objective: To evaluate the clinical outcomes of transvaginal ultrasound-guided (US-guided) radiofrequency ablation (RFA) combined with mifepristone for the treatment of large uterine fibroids. Methods: Between June 2016 and December 2018, a total of 30 patients with symptomatic uterine fibroids (!5cm) who underwent transvaginal US-guided RFA combined with mifepristone were included in this retrospective study. A matching cohort of 30 patients underwent transvaginal USguided RFA without mifepristone as controls. The technical efficacy, complications and mid-term treatment effectiveness were assessed and compared with the controls. Results: The mean volume of uterine fibroid was 168.3 ± 40.1 cm 3 . The mean ablation time was 23.5 ± 11.3 min in the combined treatment group, which was demonstrably less than that of the RFA group, which was 45.7 ± 6.8 min. The mean number of punctures was 2.2 ± 0.6 in the combined treatment group, which was significantly less than that of the RFA group. No major complications occurred. The mean percentages of regression of fibroid at 3 and 12 months after the course of the combined treatment were 73.3% and 90.1%, respectively, which were significantly more than those of the RFA group. Quality of life and symptom scores improved in both groups but to a greater extent in the combined treatment group. Conclusions: US-guided RFA combined with mifepristone might be a simple, safe and effective alternative for the treatment of large uterine fibroids.

Study on the Efficacy of Different Doses of Mifepristone in the Treatment of Uterine Fibroids

“…A rat experiment showed that the role of Mif in drug abortion may be related to increase in expression levels of Malondialdehyde (MDA), activated caspase 3, caspase 9 and recombinant B-cell lymphoma 2 (Bcl-2)-associated X protein (BAX), as well as the down-regulation of Superoxide Dismutase (SOD) and Bcl-2 [13] . Besides, compared with RFA intervention alone, Mif combined with ultrasoundguided Radiofrequency Ablation (RFA) for large UFs has been indicated to not only significantly reduce the mean ablation time and mean number of punctures, but also improve the average resolution rate of UFs, the quality of life and symptom scores without causing major complications, suggesting that Mif also has certain therapeutic potential in large UFs [14] . The dosage of Mif in the treatment of UFs is still controversial.…”

The efficacy and safety of Chinese herbal medicine Guizhi Fuling capsule combined with low dose mifepristone in the treatment of uterine fibroids: a systematic review and meta-analysis of 28 randomized controlled trials

“…Mifepristone, an anabolic steroid with antiprogesterone and antiglucocorticoid activity, is a commonly used SPRM. MFP is effective and well-tolerated in the treatment of UFs [ 19 , 21 , 22 ]. Multiple past studies have demonstrated that low-dose MFP maintains the same efficacy and has fewer adverse effects than high-dose MFP [ 20 , 23 – 25 ].…”