Wallace A N, Tomasian A, Vaswani D, Vyhmeister R, Chang R O, Jennings J W
From the Mallinckrodt Institute of Radiology (A.N.W., A.T., D.V., J.W.J.), Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri
From the Mallinckrodt Institute of Radiology (A.N.W., A.T., D.V., J.W.J.), Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri.
AJNR Am J Neuroradiol. 2016 Apr;37(4):759-65. doi: 10.3174/ajnr.A4595. Epub 2015 Dec 3.
Combination radiofrequency ablation and vertebral augmentation is an emerging minimally invasive therapy for patients with metastatic spine disease who have not responded to or have contraindications to radiation therapy. The purpose of this study was to evaluate the rate of radiographic local control of spinal metastases treated with combination radiofrequency ablation and vertebral augmentation.
We retrospectively reviewed our tumor ablation database for all patients who underwent radiofrequency ablation and vertebral augmentation of spinal metastases between April 2012 and July 2014. Tumors treated in conjunction with radiation therapy were excluded. Tumor characteristics, procedural details, and complications were recorded. Posttreatment imaging was reviewed for radiographic evidence of tumor progression.
Fifty-five tumors met study inclusion criteria. Radiographic local tumor control rates were 89% (41/46) at 3 months, 74% (26/35) at 6 months, and 70% (21/30) at 1 year after treatment. Clinical follow-up was available in 93% (51/55) of cases. The median duration of clinical follow-up was 34 weeks (interquartile range, 15-89 weeks), during which no complications were reported and no patients had clinical evidence of metastatic spinal cord compression at the treated levels.
Combination radiofrequency ablation and vertebral augmentation appears to be an effective treatment for achieving local control of spinal metastases. A prospective clinical trial is now needed to replicate these results.
对于转移性脊柱疾病患者，若对放射治疗无反应或存在放射治疗禁忌证，联合射频消融与椎体强化术是一种新兴的微创治疗方法。本研究的目的是评估联合射频消融与椎体强化术治疗脊柱转移瘤的影像学局部控制率。
我们回顾性分析了2012年4月至2014年7月期间接受脊柱转移瘤射频消融与椎体强化术的所有患者的肿瘤消融数据库。排除联合放射治疗的肿瘤。记录肿瘤特征、手术细节及并发症。复查治疗后的影像学资料以寻找肿瘤进展的影像学证据。
55个肿瘤符合研究纳入标准。治疗后3个月、6个月和1年的影像学局部肿瘤控制率分别为89%（41/46）、74%（26/35）和70%（21/30）。93%（51/55）的病例有临床随访资料。临床随访的中位时间为34周（四分位间距，15 - 89周），在此期间未报告并发症，且治疗节段无患者出现转移性脊髓压迫的临床证据。
联合射频消融与椎体强化术似乎是实现脊柱转移瘤局部控制的有效治疗方法。现在需要进行一项前瞻性临床试验以验证这些结果。
