Division of Interventional Radiology, Cisanello University Hospital, Pisa, Italy.
Department of Diagnostic and Interventional Radiology, Sohag University Hospital, Sohag, Egypt.
Curr Med Imaging. 2021;17(2):166-178. doi: 10.2174/1573405616666200825162712.
This article represents a review of the use of image-guided cryotherapy in the treatment of musculoskeletal tumor lesions. Cryotherapy is able to induce a lethal effect on cancer cells through direct and indirect mechanisms. In this manuscript, we combined our experience with that of other authors who have published on this topic in order to provide indications on when to use cryotherapy in musculoskeletal oncology.
Image-Guided percutaneous cryotherapy is a therapeutic method now widely accepted in the treatment of patients with musculoskeletal tumors. It can be used both for palliative treatments of metastatic bone lesions and for the curative treatment of benign bone tumors, such as osteoid osteoma or osteoblastoma. In the treatment of bone metastases, cryotherapy plays a major role in alleviating or resolving disease-related pain, but it has also been demonstrated that it can have a role in local disease control. In recent years, the use of cryotherapy has also expanded for the treatment of both benign and malignant soft tissue tumors.
Percutaneous cryotherapy can be considered a safe and effective technique in the treatment of benign and malignant musculoskeletal tumors. Cryotherapy can be considered the first option in benign tumor lesions, such as osteoid osteoma, and a valid alternative to radiofrequency ablation. In the treatment of painful bone metastases, it must be considered secondarily to other standard treatments (radiotherapy, bisphosphonate therapy, and chemotherapy) when they are no longer effective in controlling the disease or when they cannot be repeated (for example, radiotherapy).
本文是对影像引导下冷冻治疗在治疗肌肉骨骼肿瘤病变中的应用的综述。冷冻疗法能够通过直接和间接机制对癌细胞产生致命影响。在本文中，我们结合了我们的经验和其他已经发表过相关主题文章的作者的经验，为肌肉骨骼肿瘤学中何时使用冷冻治疗提供了指导。
影像引导下经皮冷冻治疗是一种在治疗肌肉骨骼肿瘤患者中广泛接受的治疗方法。它既可以用于治疗转移性骨病变的姑息性治疗，也可以用于治疗良性骨肿瘤，如骨样骨瘤或骨母细胞瘤。在骨转移的治疗中，冷冻治疗在缓解或解决与疾病相关的疼痛方面起着重要作用，但也已经证明它在局部疾病控制方面也有作用。近年来，冷冻治疗在治疗良性和恶性软组织肿瘤方面的应用也有所扩大。
经皮冷冻治疗在治疗良性和恶性肌肉骨骼肿瘤方面可以被认为是一种安全有效的技术。冷冻治疗可以被认为是良性肿瘤病变（如骨样骨瘤）的首选治疗方法，也是射频消融术的有效替代方法。在治疗疼痛性骨转移时，当其他标准治疗（放疗、双磷酸盐治疗和化疗）不再有效或无法重复（例如放疗）时，它必须被视为二线治疗选择。
