Service d'Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg, 1, Place de l'hopital, 67000 Strasbourg, France.
Service d'Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg, 1, Place de l'hopital, 67000 Strasbourg, France.
Clin Radiol. 2021 Sep;76(9):674-680. doi: 10.1016/j.crad.2021.05.013. Epub 2021 Jun 11.
To assess pain relief and local tumour control retrospectively in spinal metastases undergoing cryoablation.
Between May 2008 and September 2020, 46 metastases in 41 consecutive patients (mean age 59.7±4.4 [SD] years; range 27-84) were treated with cryoablation in 42 interventional sessions. Patient demographics, procedural data, complications, pain, and local tumour control were analysed retrospectively.
Thirty-one patients (36 spine metastases; 32 sessions) were treated for pain relief and 10 (10 metastases; 10 sessions) for local tumour control. Clinical success was reached in 30/32 (93.8%) interventional palliative sessions. Mean pre-procedural numerical pain rate scale was 6.2±1.7 (SD), and dropped significantly to 3.5±1.8 (SD), 1.9±1.7 (SD), and 1.9±1.8 (SD) at 24-h, 1-month and at the last available follow-up (median 16.5±23.2 [SD] months), respectively. For patients requiring local tumour control, primary clinical success was reached in 6/10 (60%) spinal metastases at median 25-months follow-up. The overall complication rate was 8%, with no secondary fractures or iatrogenic thermal-mediated nerve injuries reported.
Percutaneous image-guided cryoablation of spinal metastases is safe and effective in achieving pain relief and local tumour control.
回顾性评估脊柱转移瘤行冷冻消融治疗后的止痛效果和局部肿瘤控制情况。
2008 年 5 月至 2020 年 9 月,41 例连续患者的 46 个转移灶(平均年龄 59.7±4.4[SD]岁;范围 27-84 岁)在 42 次介入治疗中接受了冷冻消融治疗。回顾性分析患者的人口统计学数据、手术过程数据、并发症、疼痛和局部肿瘤控制情况。
31 例患者(36 个脊柱转移灶;32 次治疗)接受了止痛治疗,10 例患者(10 个转移灶;10 次治疗)接受了局部肿瘤控制治疗。32 次姑息性介入治疗中,有 30 次(93.8%)达到临床成功。术前数字疼痛评分量表的平均评分从 6.2±1.7(SD)显著降至 24 小时后的 3.5±1.8(SD)、1 个月后的 1.9±1.7(SD)和最后一次随访时的 1.9±1.8(SD)(中位数随访时间为 16.5±23.2[SD]个月)。对于需要局部肿瘤控制的患者,10 个脊柱转移灶中有 6 个(60%)在中位随访 25 个月时达到了主要临床成功。总的并发症发生率为 8%,没有报告继发性骨折或医源性热介导的神经损伤。
经皮影像引导下冷冻消融治疗脊柱转移瘤在缓解疼痛和局部肿瘤控制方面是安全有效的。