Department of Radiology, All India Institute of Medical Sciences, New Delhi, India.
J Palliat Med. 2010 Feb;13(2):117-20. doi: 10.1089/jpm.2009.0243.
The aim of this study was to evaluate the efficacy of transarterial alcohol ablation of renal cell carcinoma (RCC) with distant metastasis for control of symptoms caused by primary disease. This was a retrospective study consisting of eight patients having stage IV RCC. The primary indication for embolization was hematuria in seven patients and flank pain in one patient. All eight patients underwent renal artery embolization with ethanol and gelatin sponge pledgets. After embolization periodic evaluation was done every 3 months up to 1 year. Patients treated for hematuria did not complain of hematuria at 3- and 6-month follow-up except one who died of disease after 5 months. At 9-month follow-up five patients were free of hematuria while one developed hematuria after 6 months of treatment and died after 8 months. After 1 year three patients had no hematuria. One patient who developed hematuria at 9 months died after 11 months, another patient died of cardiac arrest at 10 months. The only patient who was treated for flank pain did not complain of pain up to 1-year follow-up. To conclude, transarterial embolization of renal tumor using ethanol is very effective in controlling local symptoms such as hematuria and pain. Thus, it may be an alternative treatment offered to symptomatic patients who are either not fit for surgery or not willing to undergo surgery.
本研究旨在评估经动脉酒精消融治疗伴远处转移的肾细胞癌（RCC）以控制原发病引起的症状的疗效。这是一项回顾性研究，共纳入 8 例 IV 期 RCC 患者。栓塞的主要适应证为 7 例血尿和 1 例腰痛。所有 8 例患者均接受了肾动脉乙醇和明胶海绵栓塞治疗。栓塞后每 3 个月至 1 年定期进行评估。接受血尿治疗的患者在 3 个月和 6 个月的随访中未出现血尿，除 1 例患者在 5 个月后因疾病死亡外。9 个月随访时，5 例患者无血尿，1 例患者在治疗 6 个月后出现血尿，并在 8 个月后死亡。1 年后，3 例患者无血尿。1 例在 9 个月时出现血尿的患者在 11 个月后死亡，另 1 例患者在 10 个月时因心脏骤停死亡。唯一接受腰痛治疗的患者在 1 年随访期间未出现疼痛。总之，经动脉肿瘤栓塞术用乙醇治疗肾肿瘤在控制血尿和疼痛等局部症状方面非常有效。因此，它可能是一种可供有症状且不适合手术或不愿手术的患者选择的替代治疗方法。
