Department of Interventional Radiology, Nouvel Hôpital Civil, Hopitaux Universitaires de Strasbourg, 67096 Strasbourg, France; Department of Musculoskeletal Radiology, Centre Hospitalier Universitaire de Lille, 59000 Lille, France.
Department of Interventional Radiology, Nouvel Hôpital Civil, Hopitaux Universitaires de Strasbourg, 67096 Strasbourg, France.
Diagn Interv Imaging. 2021 Jan;102(1):27-34. doi: 10.1016/j.diii.2020.04.012. Epub 2020 May 29.
To investigate the safety and clinical efficacy of bipolar radiofrequency ablation (b-RFA) with increased (>70°C) target temperature for the treatment of spine metastases with the intent of achieving pain relief or local tumor control.
Thirty-one patients with a total of 37 metastases who were treated with b-RFA with increased temperature and vertebroplasty from January 2016 to May 2019 were retrospectively included. There were 20 women and 11 men with a mean age of 62.4±10.5 (SD) years (range: 40-78years). Patients and metastases characteristics, procedure details and clinical outcomes were analyzed.
Metastases were predominantly located in lumbar (22/37; 59.5%) or thoracic spine (13/37; 35.1%). Mean target temperature was 88.4±3.5 (SD) °C (range: 70-90°C). Technical success was 100% (37/37 metastases). One (1/37; 2.7%) major complication unrelated to b-RFA was reported. One (1/37; 2.7%) metastasis was lost to follow-up. Favorable outcome was noted in patients receiving b-RFA for pain management (16/20 metastases; 80%; mean follow-up, 3.4±2.9 [SD] months) or with oligometastatic/oligoprogressive disease (6/6 metastases; 100%; mean follow-up, 5.0±4.6 [SD] months). In patients receiving b-RFA to prevent complications, favorable outcome was noted in 6/10 metastases (60%; mean follow-up, 3.8±4.8 [SD] months).
B-RFA with increased target temperature has an excellent safety profile and results in high rates of pain relief and local metastasis control in patients with oligometastatic/oligoprogressive disease. Suboptimal results are achieved in patients receiving b-RFA to prevent complications related to the growth of the index tumor.
探讨提高（>70°C）目标温度的双极射频消融（b-RFA）治疗脊柱转移瘤的安全性和临床疗效，以期达到缓解疼痛或局部肿瘤控制的目的。
回顾性纳入 2016 年 1 月至 2019 年 5 月期间接受高温 b-RFA 联合椎体成形术治疗的 31 例（37 个转移灶）患者。其中 20 例为女性，11 例为男性，平均年龄 62.4±10.5（SD）岁（范围：40-78 岁）。分析患者和转移灶特征、手术细节及临床结果。
转移灶主要位于腰椎（22/37；59.5%）或胸椎（13/37；35.1%）。平均目标温度为 88.4±3.5（SD）°C（范围：70-90°C）。技术成功率为 100%（37/37 个转移灶）。仅报告 1 例（1/37；2.7%）与 b-RFA 无关的主要并发症。1 例（1/37；2.7%）转移灶失访。接受 b-RFA 治疗疼痛管理（16/20 个转移灶；80%；平均随访 3.4±2.9[SD]个月）或寡转移/寡进展性疾病（6/6 个转移灶；100%；平均随访 5.0±4.6[SD]个月）的患者，疗效良好。为预防并发症而接受 b-RFA 治疗的患者中，6/10 个转移灶（60%；平均随访 3.8±4.8[SD]个月）疗效良好。
提高目标温度的 b-RFA 具有极好的安全性，可使寡转移/寡进展性疾病患者的疼痛缓解率和局部转移灶控制率均较高。为预防与指数肿瘤生长相关的并发症而接受 b-RFA 治疗的患者，疗效不理想。
