Division of Interventional Radiology, Nemours Children's Health, 1600 Rockland Rd., Wilmington, DE, 19803, USA.
Curr Oncol Rep. 2022 Dec;24(12):1731-1740. doi: 10.1007/s11912-022-01320-1. Epub 2022 Sep 3.
Pediatric interventional radiology (IR) is a growing subspecialty. Here, we review the current role of IR in children with cancer, which uses imaging such as ultrasound, fluoroscopy, and computed tomography to perform minimally invasive procedures. These include biopsy, needle localization, central venous access, thermal ablation, transarterial chemoembolization, transarterial radioembolization with yttrium-90, non-tunneled/tunneled drainage catheter placement, and lymphatic interventions.
Although locoregional therapies for the treatment of cancer in adults are common, they are less common in children, perhaps due to the relative rarity of cancer in children, their typically better performance status, and paucity of comorbidities. Preliminary results from small-scale studies for ablation, transarterial chemoembolization, and transarterial radioembolization with yttrium-90 used in the front-line armamentarium of curative therapy are encouraging. Pediatric IR offers an array of minimally invasive procedures intended to diagnose and treat pediatric cancer patients. However, more research is required to determine the efficacy of locoregional therapy in children and to define the clinical scenarios where benefit is likely to be optimized.
儿科介入放射学(IR)是一个不断发展的亚专科。在这里,我们回顾了 IR 在癌症儿童中的当前作用,该作用利用超声、透视和计算机断层扫描等影像学技术进行微创操作。这些操作包括活检、针定位、中心静脉通路、热消融、经动脉化疗栓塞、钇-90 经动脉放射性栓塞、非隧道/隧道引流导管放置以及淋巴介入。
尽管成人癌症的局部区域治疗很常见,但在儿童中却不常见,这可能是因为儿童癌症相对较少见,他们的一般表现状态较好,合并症较少。在根治性治疗的一线武器中,对消融、经动脉化疗栓塞和钇-90 经动脉放射性栓塞的小规模研究的初步结果令人鼓舞。儿科 IR 提供了一系列旨在诊断和治疗儿科癌症患者的微创操作。然而,需要更多的研究来确定局部区域治疗在儿童中的疗效,并确定可能使获益最大化的临床情况。