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经皮影像引导下骨转移瘤消融治疗:寡转移患者的局部肿瘤控制。

Percutaneous image-guided ablation of bone metastases: local tumor control in oligometastatic patients.

机构信息

a Interventional Radiology , University Hospital of Strasbourg , Strasbourg , France.

b Clinical Investigation, INSERM 1414 , University of Rennes , Rennes , France.

出版信息

Int J Hyperthermia. 2018;35(1):493-499. doi: 10.1080/02656736.2018.1508760. Epub 2018 Oct 11.

Abstract

INTRODUCTION

Percutaneous image-guided cryo- (CA) and radiofrequency- (RFA) ablations have been widely used in the treatment of painful bone metastases (BM). However, paucity of data is available for the performance of these treatments when used with a curative intent. The aim of this study is to investigate the local progression free-survival (LPFS) after radical percutaneous image-guided ablation of BM in oligometastatic patients, and to identify predictive factors associated with local tumor progression.

MATERIALS AND METHODS

This is a retrospective review of all patients who underwent percutaneous image-guided CA or RFA of BM with a radical intent between 2007 and 2018.

RESULTS

Forty-six patients with a total of forty-nine BM underwent percutaneous image-guided CA (N = 37; 75,5%) or RFA (N = 12; 24,5%). Primary malignancies included thyroid (N = 11, 22.5%), breast (N = 21; 42.9%), lung (N = 8; 16.3%) and other (N = 9; 18,3%) cancers. Additional consolidation was performed after ablation in 20.4% cases (N = 10). Mean follow-up was 34.1 ± 22 months. Local progression at the treated site was observed in 28.5% cases (N = 14); 1- and 2-year LPFS was 76.8% and 71.7%, respectively. Size of BM (>2 cm) predicted local tumor progression (p = .002).

CONCLUSIONS

Percutaneous image-guided locoregional therapies used in the radical treatment of BM in oligometastatic patients demonstrate significant rates of LPFS providing the size of BM ≤2 cm.

摘要

简介

经皮影像引导下冷冻治疗(CA)和射频消融(RFA)已广泛应用于治疗骨转移疼痛(BM)。然而,对于以根治为目的的这些治疗方法的疗效数据却很少。本研究旨在探讨寡转移患者接受根治性经皮影像引导下 BM 消融后局部无进展生存期(LPFS),并确定与局部肿瘤进展相关的预测因素。

材料和方法

这是一项回顾性研究,纳入了 2007 年至 2018 年间接受根治性经皮影像引导下 CA 或 RFA 治疗 BM 的所有患者。

结果

46 例患者共 49 处 BM 接受了经皮影像引导下 CA(N=37;75.5%)或 RFA(N=12;24.5%)治疗。原发恶性肿瘤包括甲状腺(N=11;22.5%)、乳腺(N=21;42.9%)、肺(N=8;16.3%)和其他(N=9;18.3%)癌症。消融后 20.4%的患者(N=10)进行了巩固治疗。平均随访时间为 34.1±22 个月。14 例(28.5%)患者治疗部位出现局部进展,1 年和 2 年 LPFS 分别为 76.8%和 71.7%。BM 大小(>2cm)预测局部肿瘤进展(p=0.002)。

结论

在寡转移患者的 BM 根治性治疗中,经皮影像引导下局部区域治疗显示出较高的 LPFS 率,前提是 BM 直径≤2cm。

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