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经皮超声引导下恶性骨溶解的射频热消融术

Percutaneous ultrasound-guided radiofrequency thermal ablation of malignant osteolyses.

作者信息

Poggi Guido, Gatti Carlo, Melazzini Mario, Bernardo Giovanni, Strada Mariarosa, Teragni Cristina, Delmonte Angelo, Tagliaferri Carlo, Bonezzi Cesare, Barbieri Massimo, Bernardo Antonio, Fratino Pietro

机构信息

U.O. Oncologia II, IRCCS Fondazione S. Maugeri, Pavia, Italy.

出版信息

Anticancer Res. 2003 Nov-Dec;23(6D):4977-83.

Abstract

Metastases are the most common neoplastic pathology involving the skeletal system. The hallmark of skeletal metastases is pain that often compromises the patient's quality of life. Radiotherapy, surgery and chemotherapy are the cornerstones of the treatment, but these techniques are not completely effective. Radiofrequency thermal ablation (RFA) may offer an alternative to conventional therapies for pain control. At present, the main field of application of RFA is the treatment of primary or secondary tumors of the liver but, recently, the technique has been effectively used to treat various other tumors in organs such as the prostate, kidney, lung, brain, pancreas and breast and to control pain caused by osteoid osteomas. Five patients with six painful bone metastases underwent RFA. The patients were three women and two men, aged 40-77 years (mean: 63.4). The radiofrequency system consists of an insulated 18-gauge needle electrode attached to a 500-kHz RF generator (Radionics, Burlington, Mass, USA). Four of our five patients rapidly obtained pain relief. One patient was completely pain free within 48 hours of the procedure and the control of pain persisted for 88 weeks. Another three patients obtained at least fifty percent pain reduction that lasted, on average, 12 weeks. Our preliminary results confirm that ultrasound-guided RFA is a simple and safe technique for treating painful superficial bone metastases.

摘要

转移瘤是累及骨骼系统最常见的肿瘤性病变。骨转移瘤的标志是疼痛,这常常会影响患者的生活质量。放疗、手术和化疗是治疗的基石,但这些技术并非完全有效。射频热消融(RFA)可能为控制疼痛的传统疗法提供一种替代方案。目前,RFA的主要应用领域是治疗肝脏的原发性或继发性肿瘤,但最近,该技术已被有效地用于治疗前列腺、肾脏、肺、脑、胰腺和乳腺等器官的各种其他肿瘤,并用于控制骨样骨瘤引起的疼痛。5例伴有6处疼痛性骨转移的患者接受了RFA治疗。患者为3名女性和两名男性,年龄40 - 77岁(平均63.4岁)。射频系统由连接到500kHz射频发生器(美国马萨诸塞州伯灵顿市的Radionics公司)的绝缘18号针状电极组成。我们的5例患者中有4例迅速获得了疼痛缓解。1例患者在手术后48小时内完全无痛,疼痛控制持续了88周。另外3例患者疼痛至少减轻了50%,平均持续12周。我们的初步结果证实,超声引导下的RFA是一种治疗浅表疼痛性骨转移瘤的简单、安全的技术。

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