Arrigoni Francesco, Bianchi Giampaolo, Formiconi Francesco, Palumbo Pierpaolo, Zugaro Luigi, Gravina Giovanni Luca, Barile Antonio, Masciocchi Carlo
Department of Emergency and Interventional Radiology, San Salvatore Hospital, L'Aquila, Italy.
U.O.C. Radiology and Interventional Radiology, San Filippo E Nicola Hospital, Avezzano, Italy.
Radiol Med. 2022 Feb;127(2):199-205. doi: 10.1007/s11547-021-01437-6. Epub 2021 Dec 10.
Thermal ablation techniques are procedures of growing interest for management of bone metastases. Among these, cryoablation is probably the most advanced. It allows treatment of large and irregular volumes of pathological tissue, real-time evaluation of the area of ablation and appears less painful than heat-based ablative techniques like radiofrequency and microwaves. Literature shows the effectiveness of cryoablation in the management of bone metastases in terms of pain palliation, but also its employment with curative intent is recommended. We reviewed the outcomes of cryoablation procedures performed in our radiology department over the last seven years, confirming the results in terms of pain palliation and local control of disease. We retrospectively evaluated results of 28 procedures of cryoablation, of which 17 treated with palliative and 11 with curative intent. In a 3-month follow-up study, we recorded an overall reduction of pain (evaluated using a VAS 0-10 scale) between pre- and post-treatment. The mean values dropped from 6.9 (SD: ± 1.3) to 3.5 (SD ± 2.6) (p < 0.0001). In the group of patients treated for local tumor control (follow-up: 22.4 months), we recorded a stability and/or reduction in volume of the lesion in 10 out 11 patients. No major complications were recorded.
热消融技术是治疗骨转移瘤越来越受关注的方法。其中,冷冻消融可能是最先进的。它能够治疗大面积且不规则的病理组织,可实时评估消融区域,并且似乎比射频和微波等热消融技术引起的疼痛更少。文献表明,冷冻消融在缓解骨转移瘤疼痛方面是有效的,同时也建议将其用于根治性治疗。我们回顾了过去七年在我们放射科进行的冷冻消融手术的结果,证实了其在缓解疼痛和局部疾病控制方面的效果。我们回顾性评估了28例冷冻消融手术的结果,其中17例为姑息性治疗,11例为根治性治疗。在一项为期3个月的随访研究中,我们记录了治疗前后疼痛(使用0 - 10分视觉模拟量表评估)的总体减轻情况。平均值从6.9(标准差:±1.3)降至3.5(标准差±2.6)(p < 0.0001)。在接受局部肿瘤控制治疗的患者组(随访:22.4个月)中,我们记录到11例患者中有10例病变体积稳定和/或缩小。未记录到重大并发症。