Cazzato R L, Bonichon F, Buy X, Godbert Y, de Figuereido B H, Pointillart V, Palussière J
Department of "Diagnostica per Immagini e Radiologia Interventistica", Università "Campus Bio-Medico di Roma", Via Alvaro del Portillo, 200, 00128 Rome, Italy; Department of Radiology, Institut Bergonié, 229 Cours de l'Argonne, 33076 Bordeaux Cedex, France.
Department of Nuclear Medicine, Institut Bergonié, 229 Cours de l'Argonne, 33076 Bordeaux Cedex, France.
Eur J Surg Oncol. 2015 Sep;41(9):1247-55. doi: 10.1016/j.ejso.2015.06.005. Epub 2015 Jun 21.
Percutaneous image-guided treatments (PIGT) are performed by interventional radiologists with a minimally invasive approach. Currently, very little published data on their outcomes are available and conclusions regarding their application are cautious. The aim of the present study was to review our experience in PIGT of bone metastases from thyroid cancer.
Institutional databases were reviewed to identify patients with differentiated thyroid cancer and bone metastases who received PIGT between October 2001 and April 2014. Complications, local evolution of the treated lesions, and overall survival (OS) were investigated.
Twenty-five patients (12 male, 13 female) underwent 49 PIGT sessions consisting of cementoplasty (77.5%), cryoablation (14.3%) or radiofrequency ablation (8.2%). Most of the treated lesions (50/54, 92.6%) were symptomatic at the time of PIGT. Median follow-up after PIGT was 4.6 years. Local complete remission rate was 55.6%. Two complications (one major and one minor) were noted, but none of these were consistent with fractures or nervous system injuries. OS after PIGT was 71.6%, 66.8% and 60.1% at 1, 2 and 3 years, respectively. A difference in survival was observed between patients with metastatic bone involvement only at the time of first PIGT compared to those with multi-organ involvement (P = 0.03).
Patients with bone metastases from differentiated thyroid cancer may benefit from PIGT. Although patients are usually referred for PIGT due to their symptomatic status, a more relevant "curative" role may exist for PIGT. Further prospective studies are needed to confirm this perception.
经皮影像引导治疗（PIGT）由介入放射科医生采用微创方法进行。目前，关于其治疗效果的已发表数据非常少，关于其应用的结论也较为谨慎。本研究的目的是回顾我们在甲状腺癌骨转移的经皮影像引导治疗方面的经验。
回顾机构数据库，以确定2001年10月至2014年4月期间接受经皮影像引导治疗的分化型甲状腺癌和骨转移患者。调查并发症、治疗病变的局部演变以及总生存期（OS）。
25例患者（12例男性，13例女性）接受了49次经皮影像引导治疗，包括骨水泥成形术（77.5%）、冷冻消融（14.3%）或射频消融（8.2%）。大多数接受治疗的病变（50/54，92.6%）在接受经皮影像引导治疗时出现症状。经皮影像引导治疗后的中位随访时间为4.6年。局部完全缓解率为55.6%。记录到2例并发症（1例严重和1例轻微），但这些均与骨折或神经系统损伤无关。经皮影像引导治疗后1年、2年和3年的总生存率分别为71.6%、66.8%和60.1%。仅在首次经皮影像引导治疗时出现骨转移的患者与多器官受累患者的生存率存在差异（P = 0.03）。
分化型甲状腺癌骨转移患者可能从经皮影像引导治疗中获益。尽管患者通常因症状而接受经皮影像引导治疗，但经皮影像引导治疗可能存在更相关的“治愈性”作用。需要进一步的前瞻性研究来证实这一观点。
