Gatto L, Facchini G, Saponara M, Nannini M, Rossi G, Di Scioscio V, Biasco G, Pantaleo M A
Department of Specialized, Experimental and Diagnostic Medicine, Sant'Orsola-Malpighi Hospital, Unifversiti of Bologna, via Massarenti n. 9, 40138 Bologna, Italy.
Department of Interventional Angiographic Radiology, Istituto Ortopedico Rizzoli, Bologna, Italy.
Radiol Case Rep. 2017 Aug 16;12(4):775-779. doi: 10.1016/j.radcr.2017.07.008. eCollection 2017 Dec.
Herein is described the case of a 64-year-old patient affected by metastatic clear-cell carcinoma, with exclusive bone disease, subjected after the initial cytoreductive nephrectomy to 3 successive lines of medical treatment (sunitinib, everolimus, and sorafenib) and multiple locoregional treatments (spinal surgery, radiation therapy, and selective arterial embolization), resulting in a surprisingly long survival of over 75 months. In the era of target therapy, integration strategies, including additional locoregional treatment to medical therapy, are essential to optimize the clinical benefit, to maximize treatment duration overcoming focal progressive disease, and to improve the quality of life. In this context, we would highlight that selective transcatheter embolization of bone metastases from renal cell carcinoma should be considered as an effective and safe option in the palliative setting for patients with bone metastasis, especially for pain relief.
本文描述了一例64岁转移性透明细胞癌患者的病例,该患者仅患有骨转移疾病,在初次减瘤性肾切除术后接受了3个连续疗程的药物治疗(舒尼替尼、依维莫司和索拉非尼)以及多次局部区域治疗(脊柱手术、放射治疗和选择性动脉栓塞),其生存期令人惊讶地长达75个月以上。在靶向治疗时代,整合策略,包括在药物治疗基础上增加局部区域治疗,对于优化临床获益、最大化治疗持续时间以克服局部进展性疾病以及改善生活质量至关重要。在此背景下,我们强调,对于骨转移的肾细胞癌患者,尤其是为缓解疼痛,在姑息治疗中应将选择性经导管骨转移瘤栓塞术视为一种有效且安全的选择。