Department of Radiology, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
School of Biomedical Engineering and Imaging Sciences, Kings College London, London, United Kingdom.
Semin Musculoskelet Radiol. 2020 Dec;24(6):710-725. doi: 10.1055/s-0040-1719104. Epub 2020 Dec 11.
Percutaneous image-guided oncologic interventions have rapidly evolved over the last two decades as an independent strategy or used within a first-, second-, or even third-line strategy in the treatment of musculoskeletal (MSK) tumors. Abundant mostly nonrandomized publications have described the safety, efficacy, and reproducibility of implementing percutaneous therapies both with curative and palliative intent. In this article, we continue to share our experience in bone and MSK soft tissue interventions focusing on stabilization and combined ablation and stabilization. We propose a pathway and explore future directions of image-guided interventional oncology related to skeletal disease. We reflect on the advantages and limitations of each technique and offer guidance and pearls to improve outcomes. Representing patterns from our practices, we demonstrate the role of collaborative working within a multidisciplinary team, ideally within a dedicated tumor treatment center, to deliver patient-specific therapy plans that are value based and favored by patients when given the choice.
在过去的二十年中,经皮影像引导的肿瘤介入治疗作为一种独立的治疗策略,或在一线、二线甚至三线治疗策略中得到了广泛应用,在治疗肌肉骨骼(MSK)肿瘤方面取得了快速发展。大量非随机出版物描述了经皮治疗在治疗和姑息治疗方面的安全性、有效性和可重复性。在本文中,我们继续分享我们在骨和 MSK 软组织介入治疗方面的经验,重点是稳定和联合消融及稳定。我们提出了一种途径,并探讨了与骨骼疾病相关的影像引导肿瘤介入治疗的未来方向。我们反思了每种技术的优点和局限性,并提供了一些指导和技巧,以提高治疗效果。通过展示我们实践中的模式,我们展示了在多学科团队中协作工作的作用,理想情况下是在专门的肿瘤治疗中心内,为患者提供基于价值的个体化治疗方案,并在患者有选择的情况下得到患者的青睐。