Gevargez Athour, Groenemeyer Dietrich H W
Groenemeyer Institute of MicroTherapy, Bochum, Germany.
Eur J Radiol. 2008 Feb;65(2):246-52. doi: 10.1016/j.ejrad.2007.03.026. Epub 2007 May 23.
To evaluate retrospectively the efficacy and safety of radiofrequency ablation (RFA) in patients with spinal tumors.
Forty-one patients (25 men, 16 women; age range, 46-82 years) with nonresectable primary or secondary tumor involvement of the spine unresponsive to chemo- and radiotherapy received RFA treatment. Two radiofrequency ablation systems, one with a cool-tip electrode and one with an expandable electrode catheter, were used. Both systems work impedance controlled with a power output of 150- 200 W. Each coagulation cycle lasted 12-15 min depending on tumor impedance. Several single RFA cycles of 15 min each were used for overlapping RFAs in tumors with diameters of more than 3 cm. Temperature was kept between 50 degrees C and 120 degrees C and was chosen according to spinal cord distance and patient heat tolerance during the ablation. Multi-slice computed tomography (CT) combined with C-arm fluoroscopy guided the intervention. Efficacy outcomes were assessed after about 6 weeks, 6 months, and more than 6 months using standardized questionnaires and indices regarding tumor pain, pain disability, functional activities, quality of life, neurological status, and tumor progression.
RFA significantly reduced tumor-induced pain within 6 weeks, improved daily activities, and maintained quality of life. Mean time to tumor progression was 730+/-54 days (Kaplan-Meier estimate). No RFA-associated complications were reported.
RFA of primary and secondary spinal tumors, which were unresponsive to chemo- and radiotherapy and prone to progression, is a safe, resource-saving, and highly effective percutaneous technique in patients with nonresectable spinal tumors.
回顾性评估射频消融（RFA）治疗脊柱肿瘤患者的疗效和安全性。
41例（25例男性，16例女性；年龄范围46 - 82岁）对化疗和放疗无反应的不可切除原发性或继发性脊柱肿瘤患者接受了RFA治疗。使用了两种射频消融系统，一种带有冷循环电极，另一种带有可扩张电极导管。两种系统均采用工作阻抗控制，功率输出为150 - 200W。每个凝固周期持续12 - 15分钟，具体取决于肿瘤阻抗。对于直径超过3cm的肿瘤，采用多个15分钟的单次RFA周期进行重叠射频消融。在消融过程中，温度保持在50℃至120℃之间，并根据脊髓距离和患者耐热性进行选择。多层螺旋计算机断层扫描（CT）结合C形臂荧光透视引导干预。在大约6周、6个月和6个月以上时，使用关于肿瘤疼痛、疼痛残疾、功能活动、生活质量、神经状态和肿瘤进展的标准化问卷和指标评估疗效结果。
RFA在6周内显著减轻了肿瘤引起的疼痛，改善了日常活动，并维持了生活质量。肿瘤进展的平均时间为730±54天（Kaplan - Meier估计）。未报告与RFA相关的并发症。
对于对化疗和放疗无反应且易于进展的原发性和继发性脊柱肿瘤，RFA是一种安全、节省资源且高效的经皮技术，适用于不可切除脊柱肿瘤患者。
