Thariat J, Leysalle A, Vignot S, Marcy P-Y, Lacout A, Bera G, Lagrange J-L, Clezardin P, Chiras J
Département de radiothérapie oncologique, centre Antoine-Lacassagne, institut universitaire de la face et du cou, Nice, France.
Cancer Radiother. 2012 Sep;16(5-6):330-8. doi: 10.1016/j.canrad.2012.05.016. Epub 2012 Aug 24.
Solitary metastases have been reported in up to 30% of cases in imaging series. Local treatment aims at consolidating the injured bone and to prevent neurologic complications. Since the prognosis of bony metastatic disease is about 30 months and includes some long survivors, the multisdisciplinary committee in charge of the patient should ask the question and decide on the type of radical/ablative intervention in case of oligometastases. A literature search was performed using MESH terms (bone, metastases, radiotherapy, radiology, cement, radiofrequency ablation, chemoembolisation). Local ablative treatments can yield symptomatic relief and local control rates of about 90%. Stereotactic hypofractionated irradiation and cementoplasty are increasingly used. In conclusion, local ablative treatment of bony oligometastases is an efficient treatment. Its potential impact on survival remains to be demonstrated prospectively in clinical trials.
在影像学系列报道中,高达30%的病例存在孤立性转移。局部治疗旨在巩固受损骨骼并预防神经并发症。由于骨转移性疾病的预后约为30个月,且有一些长期存活者,负责该患者的多学科委员会应提出问题,并在出现寡转移的情况下决定根治性/消融性干预的类型。使用医学主题词(骨、转移、放射治疗、放射学、骨水泥、射频消融、化学栓塞)进行了文献检索。局部消融治疗可产生症状缓解,局部控制率约为90%。立体定向低分割放疗和骨水泥成形术的应用越来越多。总之,骨寡转移的局部消融治疗是一种有效的治疗方法。其对生存的潜在影响仍有待在临床试验中进行前瞻性验证。