Department of Interventional Radiology, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD 21287.
Department of Interventional Radiology, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD 21287.
J Vasc Interv Radiol. 2020 Nov;31(11):1753-1762. doi: 10.1016/j.jvir.2020.08.002. Epub 2020 Oct 1.
A systematic review and meta-analysis of pain response after radiofrequency (RF) ablation over time for osseous metastases was conducted in 2019. Analysis used a random-effects model with GOSH plots and meta-regression. Fourteen studies comprising 426 patients, most with recalcitrant pain, were identified. Median pain reduction after RF ablation was 67% over median follow-up of 24 weeks (R = -.66, 95% confidence interval -0.76 to -0.55, I = 71.24%, fail-safe N = 875) with 44% pain reduction within 1 week. A low-heterogeneity subgroup was identified with median pain reduction after RF ablation of 70% over 12 weeks (R = -.75, 95% confidence interval -0.80 to -0.70, I = 2.66%, fail-safe N = 910). Addition of cementoplasty after RF ablation did not significantly affect pain scores. Primary tumor type and tumor size did not significantly affect pain scores. A particular, positive association between pain after RF ablation and axial tumors was identified, implying possible increased palliative effects for RF ablation on axial over appendicular lesions. RF ablation is a useful palliative therapy for osseous metastases, particularly in patients with recalcitrant pain.
2019 年对射频 (RF) 消融治疗骨转移后疼痛反应的系统评价和荟萃分析。分析采用随机效应模型和 GOSH 图及荟萃回归。确定了 14 项研究，共 426 例患者，大多数为难治性疼痛。在中位随访 24 周后，RF 消融后的中位疼痛缓解率为 67%（R =-.66，95%置信区间 -0.76 至 -0.55，I = 71.24%，失效安全 N = 875），其中 44%的疼痛缓解在 1 周内。确定了一个低异质性亚组，在 12 周后 RF 消融后的中位疼痛缓解率为 70%（R =-.75，95%置信区间 -0.80 至 -0.70，I = 2.66%，失效安全 N = 910）。在 RF 消融后添加骨水泥成形术并不会显著影响疼痛评分。原发肿瘤类型和肿瘤大小并不显著影响疼痛评分。在 RF 消融后疼痛与轴性肿瘤之间存在特定的正相关关系，这表明 RF 消融对轴性病变比附肢病变的姑息效果可能增加。RF 消融是治疗骨转移的一种有效姑息疗法，特别是对难治性疼痛的患者。
