Department of Radiology, University of Southern California, Los Angeles, California, USA.
Mallinckrodt Institute of Radiology, Washington University, St. Louis, Missouri, USA.
J Med Imaging Radiat Oncol. 2020 Feb;64(1):96-103. doi: 10.1111/1754-9485.12991.
To evaluate the safety and efficacy of minimally invasive percutaneous thermal ablation alone or in combination with cementoplasty for pain palliation and local tumour control of renal cell carcinoma osseous metastases.
Imaging-guided thermal ablation was performed in 59 renal cell carcinoma osseous metastatic tumours in 23 patients (concomitant cementoplasty in 43 tumours) selected following multidisciplinary consultations to achieve local tumour control and pain palliation (75%, 44/59) or pain palliation alone (25%, 15/59) in this retrospective study. Tumour characteristics, procedural details and complications were documented. Pain palliation was assessed using pre- and post-procedural Numeric Rating Scale scores at 1-week, 1-month, 3-month and 6-month time intervals. Pre- and post-procedural cross-sectional imaging was reviewed to assess local tumour control rates at 3-month, 6-month, and 12-month post-treatment time intervals.
All procedures were technically successful and performed as pre-operatively planned. The median pre- and post-procedural Numeric Rating Scale scores were 8.0 and 3.0 (at all time intervals), respectively (P < 0.001). Local tumour control rates were 100% (40/40), 100% (36/36) and 85% (28/33) at ≥3 months, ≥6 months and ≥12 months post-procedural time intervals, respectively. There was 1 minor complication (1.7%, 1/59).
Percutaneous thermal ablation alone or in combination with cementoplasty is safe and effective for pain palliation and local tumour control of renal cell carcinoma osseous metastases.
评估微创经皮热消融单独或联合骨水泥成形术治疗肾细胞癌骨转移瘤疼痛缓解和局部肿瘤控制的安全性和疗效。
在这项回顾性研究中,对 23 例患者的 59 个肾细胞癌骨转移瘤(43 个肿瘤同时行骨水泥成形术)进行了影像学引导下的热消融治疗,以实现局部肿瘤控制和疼痛缓解(75%,44/59)或单纯疼痛缓解(25%,15/59)。记录了肿瘤特征、手术细节和并发症。使用术前和术后 1 周、1 个月、3 个月和 6 个月的数字评分量表评估疼痛缓解情况。在治疗后 3 个月、6 个月和 12 个月的时间间隔,通过术前和术后的横断面成像评估局部肿瘤控制率。
所有手术均技术成功,按术前计划进行。中位术前和术后数字评分量表评分分别为 8.0 和 3.0(所有时间间隔,P<0.001)。≥3 个月、≥6 个月和≥12 个月的局部肿瘤控制率分别为 100%(40/40)、100%(36/36)和 85%(28/33)。有 1 例轻微并发症(1.7%,1/59)。
单独或联合骨水泥成形术的经皮热消融治疗对肾细胞癌骨转移瘤的疼痛缓解和局部肿瘤控制是安全有效的。