Department of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Department of Orthopaedic Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Cardiovasc Intervent Radiol. 2023 Jun;46(6):794-798. doi: 10.1007/s00270-023-03459-1. Epub 2023 May 15.
To investigate the safety and efficacy of palliative arterial embolization for metastases of the sternum.
This study included 10 consecutive patients (5 M, 5 F; mean age 58.1; range 37-70) with metastases of the sternum from different primary tumors, treated with palliative arterial embolization using NBCA-Lipiodol between January 2007 and June 2022. Four patients received a second embolization at the same site, for a total of 14 embolizations. Data on technical and clinical success, as well as changes in tumor size, were collected. All embolization-related complications were evaluated according to the CIRSE classification system for complications.
Post-embolization angiography showed occlusion of more than 90% of the pathological feeding vessels in all procedures. Pain score and analgesic drug consumption were reduced by 50% in all 10 patients (100%, p < 0.05). The mean duration of pain relief was 9.5 months (range 8 to 12 months, p < 0.05). Metastatic tumor size was reduced from a mean of 71.5 cm (range 41.6 to 90.3 cm) pre-embolization to a mean of 67.9 cm (range 38.5 to 86.1 cm) at the 12-month follow-up (p < 0.05). None of the patients experienced embolization-related complications.
Arterial embolization is safe and effective as a palliative treatment for patients with metastases of the sternum who did not benefit from radiation therapy or experienced recurrence in symptoms.
研究经动脉姑息性栓塞治疗胸骨转移瘤的安全性和有效性。
本研究纳入了 2007 年 1 月至 2022 年 6 月期间 10 例不同原发肿瘤转移至胸骨的患者(5 例男性,5 例女性;平均年龄 58.1 岁;范围 37-70 岁),采用 NBCA-Lipiodol 进行姑息性动脉栓塞治疗。4 例患者在同一部位接受了第二次栓塞治疗,共进行了 14 次栓塞。收集了技术和临床成功率以及肿瘤大小变化的数据。所有栓塞相关并发症均根据 CIRSE 并发症分类系统进行评估。
所有手术的栓塞后血管造影均显示 90%以上的病理性供血血管闭塞。10 例患者的疼痛评分和镇痛药消耗量均降低了 50%(100%,p<0.05)。所有患者的疼痛缓解平均持续时间为 9.5 个月(范围 8 至 12 个月,p<0.05)。转移性肿瘤大小从栓塞前的平均 71.5cm(范围 41.6 至 90.3cm)缩小至 12 个月随访时的平均 67.9cm(范围 38.5 至 86.1cm)(p<0.05)。没有患者出现栓塞相关并发症。
动脉栓塞作为一种姑息治疗方法,对于那些未从放疗中获益或症状复发的胸骨转移瘤患者是安全有效的。