Department of Radiology, Division of Vascular & Interventional Radiology, Medical College of Wisconsin, 9200 W Wisconsin Ave, Rm 2803, Milwaukee, WI 53226.
Department of Diagnostic and Interventional Radiology, University General Hospital "Attikon" Medical School, National and Kapodistrian University of Athens, Athens, Greece.
AJR Am J Roentgenol. 2023 Oct;221(4):503-516. doi: 10.2214/AJR.23.29110. Epub 2023 May 24.
Musculoskeletal interventional oncology is an emerging field that addresses the limitations of conventional therapies for bone and soft-tissue tumors. The field's growth has been driven by evolving treatment paradigms, expanding society guidelines, mounting supportive literature, technologic advances, and cross-specialty collaboration with medical, surgical, and radiation oncology. Safe, effective, and durable pain palliation, local control, and stabilization of musculoskeletal tumors are increasingly achieved through an expanding array of contemporary minimally invasive percutaneous image-guided treatments, including ablation, osteoplasty, vertebral augmentation (with or without mechanical reinforcement via implants), osseous consolidation via percutaneous screw fixation (with or without osteoplasty), tumor embolization, and neurolysis. These interventions may be used for curative or palliative indications and can be readily combined with systemic therapies. Therapeutic approaches include the combination of different interventional oncology techniques as well as the sequential application of such techniques with other local treatments, including surgery or radiation. This article reviews the current practice of interventional oncology treatments for the management of patients with bone and soft-tissue tumors with a focus on emerging technologies and techniques.
肌肉骨骼介入肿瘤学是一个新兴领域,针对传统治疗骨和软组织肿瘤的局限性。该领域的发展得益于治疗模式的不断发展、社会指南的扩大、越来越多的支持文献、技术进步以及与医学、外科和放射肿瘤学的跨专业合作。通过越来越多的现代微创经皮图像引导治疗方法,包括消融、骨成形术、椎体强化(通过植入物进行机械强化或不进行机械强化)、经皮螺钉固定的骨整合(进行或不进行骨成形术)、肿瘤栓塞和神经松解术,安全、有效和持久地缓解疼痛、控制局部肿瘤并稳定肌肉骨骼肿瘤。这些介入措施可用于治疗或姑息治疗,并可与全身治疗相结合。治疗方法包括不同介入肿瘤学技术的联合应用,以及这些技术与其他局部治疗方法(包括手术或放射治疗)的序贯应用。本文重点介绍新兴技术和技术,回顾介入肿瘤学治疗骨和软组织肿瘤患者的当前实践。