Chiras J, Shotar E, Cormier E, Clarençon F
Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France.
Paris VI University, Pierre et Marie Curie, Paris, France.
Eur J Cancer Care (Engl). 2017 Nov;26(6). doi: 10.1111/ecc.12741. Epub 2017 Sep 5.
Interventional radiology plays a significant role in the treatment of bone metastases by various techniques, percutaneous or endovascular. Vertebroplasty is the most well-studied technique for stabilisation of spine metastases as it induces satisfactory stabilisation of the vertebra and offers clear improvement of the quality of life. Due to the success of this technique cementoplasty of other bones, mainly pelvic girdle, has been largely developed. The development of reinforced cementoplasty allows treatment of pre-fractural osteolysis of some long bones. The heat due to the polymerisation of the cement induces carcinolytic effect but this effect is not as important as that which results from radiofrequency destruction. This last technique appears currently as the most important development to definitively destroy bone metastases and is progressively replacing percutaneous alcoholic destruction of such lesions. Angiographic techniques, such as endovascular embolisation, can also be very useful to reduce the risk of surgical treatment of hyper vascular metastases. Chemoembolisation is currently developed to associate pain relief induced by Endovascular embolisation and the carcinolytic effect obtained by local endovascular chemotherapy. All these techniques should develop largely during the next years.
介入放射学通过多种经皮或血管内技术在骨转移瘤的治疗中发挥着重要作用。椎体成形术是研究最为充分的用于稳定脊柱转移瘤的技术，因为它能使椎体获得令人满意的稳定效果，并显著改善生活质量。由于该技术取得成功，其他骨骼（主要是骨盆带）的骨水泥成形术也得到了很大发展。强化骨水泥成形术的发展使得一些长骨的骨折前骨质溶解得以治疗。骨水泥聚合产生的热量具有溶癌作用，但这种作用不如射频消融产生的作用重要。目前，最后这项技术似乎是彻底摧毁骨转移瘤的最重要进展，并正在逐步取代经皮酒精消融此类病变的方法。血管造影技术，如血管内栓塞，对于降低高血运转移瘤手术治疗的风险也可能非常有用。目前正在开展化疗栓塞，以将血管内栓塞引起的疼痛缓解与局部血管内化疗获得的溶癌作用相结合。在未来几年，所有这些技术都将得到很大发展。
