Department of Radiology, Vancouver General Hospital, University of British Columbia, 899 W 12th Avenue, Vancouver, BC, V52 1M9, Canada.
Skeletal Radiol. 2011 Jan;40(1):25-32. doi: 10.1007/s00256-010-1010-5. Epub 2010 Aug 5.
We report the safety and efficacy of combined radiofrequency ablation and cementoplasty in treating painful neoplastic bone lesions.
Fifty-three combined radiofrequency ablation and cementoplasty procedures were completed in 36 patients. Thirty-four vertebrae (20 lumbar, 14 thoracic), 14 acetabulae, 3 sacra, 1 pubic symphysis, and 1 humerus were treated. Patient age ranged from 34 to 81 years (mean 57.6 years, SD=12.6). Primary malignancies included: 12 breast, 5 lung, 6 multiple myeloma, 2 prostate, 2 renal cell carcinoma, 1 synovial sarcoma, 1 endometrial, 1 oral squamous cell carcinoma, 1 lymphoma, 1 colon, 1 transitional cell carcinoma, 1 colorectal, 1 cholangiocarcinoma, and 1 pheochromocytoma. Primary neoplasm location, pain levels pre- and post-procedure (as assessed using the Visual Analog Scale), number of radiofrequency (RF) treatments and any extravasation were documented.
Combined radiofrequency ablation (RFA) and cementoplasty procedures were performed with 100% technical success (53 out of 53). The mean pre-procedure and post-procedure pain, as measured by the Visual Analog Scale (VAS), was 7.2/10 and 3.4/10 respectively. Symptomatic complications included one case of self-resolving transient thermal sciatic neurapraxia following RFA and acetabuloplasty. Two cases of transient pain following epidural leaks during treatment of thoracic vertebrae and breast metastases also occurred. Non-symptomatic complications, from a variety of cases, included cement emboli to the lung, incidental, non-symptomatic leaks into the needle track, spinal canal, draining veins, disc spaces, and an intra-articular leak into the hip joint.
Combined RFA and cementoplasty appears to be safe, practical and effective in the palliative treatment of painful neoplastic lesions.
我们报告射频消融联合骨水泥成形术治疗疼痛性肿瘤性骨病变的安全性和疗效。
36 例患者共完成 53 例联合射频消融联合骨水泥成形术。治疗了 34 个椎体（20 个腰椎，14 个胸椎）、14 个髋臼、3 个骶骨、1 个耻骨联合和 1 个肱骨。患者年龄 34 岁至 81 岁（平均 57.6 岁，标准差 12.6）。原发性恶性肿瘤包括：12 例乳腺癌、5 例肺癌、6 例多发性骨髓瘤、2 例前列腺癌、2 例肾细胞癌、1 例滑膜肉瘤、1 例子宫内膜癌、1 例口腔鳞状细胞癌、1 例淋巴瘤、1 例结肠癌、1 例移行细胞癌、1 例结直肠癌、1 例胆管癌和 1 例嗜铬细胞瘤。记录了原发性肿瘤位置、术前和术后（使用视觉模拟评分法评估）的疼痛水平、射频（RF）治疗次数和任何外渗情况。
联合射频消融（RFA）和骨水泥成形术 53 例均 100%技术成功。视觉模拟评分法（VAS）测量的术前和术后平均疼痛分别为 7.2/10 和 3.4/10。症状性并发症包括 1 例 RFA 和髋臼成形术后自限性短暂热坐骨神经损伤。2 例胸腰椎转移瘤治疗过程中硬膜外漏后出现短暂疼痛。其他非症状性并发症包括各种情况下的骨水泥栓塞至肺、偶然的、无症状的漏至针道、椎管、引流静脉、椎间盘间隙和髋关节内关节液漏。
联合 RFA 和骨水泥成形术似乎是安全、实用和有效的，可用于缓解疼痛性肿瘤性病变。
