Kurup Anil Nicholas, Callstrom Matthew R
From the Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN.
Cancer J. 2016 Nov/Dec;22(6):401-410. doi: 10.1097/PPO.0000000000000233.
In the last decade, percutaneous treatment of musculoskeletal (MSK) tumors has become more established in routine clinical care while also undergoing a number of advancements. Ablative techniques to palliate painful skeletal metastases have gained wide acceptance, while goals for ablation have evolved to include local control of oligometastases and desmoid tumors. Bone consolidation or augmentation is now frequently used in conjunction with or instead of ablation of skeletal tumors to stabilize pathologic fractures or prevent further morbidity that could result from fractures caused by tumor progression. These procedures have traditionally been performed with cement injection, although additional percutaneous consolidation or stabilization devices have been developed. Techniques to monitor the ablation zone and adjacent structures intraprocedurally are now applied to increase the number of tumors amenable to treatment. These include methods to depict, displace, or monitor critical structures adjacent to targeted MSK tumors. Finally, the role of ablation in the comprehensive care of patients with MSK tumors continues to change with the evolving triage of patients between radiation therapy, surgical resection and stabilization, and percutaneous ablative and consolidative management.
在过去十年中，经皮治疗肌肉骨骼（MSK）肿瘤在常规临床护理中已变得更加成熟，同时也取得了一些进展。用于缓解疼痛性骨转移的消融技术已获得广泛认可，而消融目标已发展到包括对寡转移瘤和硬纤维瘤的局部控制。骨巩固或增强现在经常与骨骼肿瘤的消融联合使用或替代消融，以稳定病理性骨折或预防肿瘤进展所致骨折可能引起的进一步发病。这些操作传统上是通过注射骨水泥进行的，不过也已开发出其他经皮巩固或稳定装置。术中监测消融区及相邻结构的技术现在被应用于增加适合治疗的肿瘤数量。这些技术包括描绘、移位或监测与目标MSK肿瘤相邻的关键结构的方法。最后，随着患者在放射治疗、手术切除与稳定以及经皮消融和巩固治疗之间不断变化的分类，消融在MSK肿瘤患者综合治疗中的作用也在持续改变。
