Chiras Jacques, Cormier Evelyne, Baragan Hector, Jean Betty, Rose Michèle
Service de neuroradiologie, Groupe hospitalier Pitié-Salpêtrière, 47 bd de l'Hôpital, 75651 Paris Cedex 13.
Bull Cancer. 2007 Feb;94(2):161-9.
Interventional radiology takes a large place in the treatment of bone metastases by numerous techniques, percutaneous or endovascular. Vertebroplasty appears actually as the most important technique for stabilisation of spine metastases as it induces satisfactory stabilisation of the vertebra and offer clear improvement of the quality of life. Due to the success of this technique cementoplasty of other bones, mainly pelvic girdle, largely develop. The heath due to the polymerisation of the cement induce carcinolytic effect but this effect is not as important as that can be created with radiofrequency destruction. This last technique appears actually as the most important development to destroy definitively some bone metastases and replace progressively alcoholic destruction of such lesions. Angiographic techniques appear more confidential but endovascular embolization is very useful to diminish the risk of surgical treatment of hyper vascular metastases. Chemoembolization is actually developped to associate the relief of pain induced by endovascular embolization and the carcinolytic effect obtained by local endovascular chemotherapy. All these techniques should develop largely during the next years and their efficacy and safety should improve largely by treating earlier the metastasis.
介入放射学在通过多种经皮或血管内技术治疗骨转移瘤方面占据重要地位。椎体成形术实际上是稳定脊柱转移瘤的最重要技术，因为它能使椎体获得令人满意的稳定效果，并显著改善生活质量。由于该技术的成功，其他骨骼（主要是骨盆带）的骨水泥成形术得到了广泛发展。骨水泥聚合产生的热量会引发溶瘤效应，但这种效应不如射频消融产生的效应显著。实际上，后一种技术是彻底摧毁某些骨转移瘤并逐步取代此类病变酒精消融术的最重要进展。血管造影技术的应用相对较少，但血管内栓塞对于降低高血运转移瘤手术治疗的风险非常有用。目前正在开展化疗栓塞，将血管内栓塞引起的疼痛缓解与局部血管内化疗获得的溶瘤效应相结合。在未来几年，所有这些技术都将得到广泛发展，并且通过早期治疗转移瘤，它们的疗效和安全性将得到大幅提高。
