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肌肉骨骼介入的新冰河时代:经皮冷冻消融在骨与软组织肿瘤中的作用。

The New Ice Age of Musculoskeletal Intervention: Role of Percutaneous Cryoablation in Bone and Soft Tissue Tumors.

机构信息

Diagnostic and Interventional Radiology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.

Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirão Preto 14049-09, Brazil.

出版信息

Curr Oncol. 2023 Jul 17;30(7):6744-6770. doi: 10.3390/curroncol30070495.

Abstract

In the rapidly evolving field of interventional oncology, minimally invasive methods, including CT-guided cryoablation, play an increasingly important role in tumor treatment, notably in bone and soft tissue cancers. Cryoablation works using compressed gas-filled probes to freeze tumor cells to temperatures below -20 °C, exploiting the Joule-Thompson effect. This cooling causes cell destruction by forming intracellular ice crystals and disrupting blood flow through endothelial cell damage, leading to local ischemia and devascularization. Coupling this with CT technology enables precise tumor targeting, preserving healthy surrounding tissues and decreasing postoperative complications. This review reports the most important literature on CT-guided cryoablation's application in musculoskeletal oncology, including sarcoma, bone metastases, and bone and soft tissue benign primary tumors, reporting on the success rate, recurrence rate, complications, and technical aspects to maximize success for cryoablation in the musculoskeletal system.

摘要

在介入肿瘤学这个快速发展的领域中,微创方法,包括 CT 引导下的冷冻消融术,在肿瘤治疗中发挥着越来越重要的作用,特别是在骨和软组织癌症方面。冷冻消融术使用充满压缩气体的探针将肿瘤细胞冷冻到低于-20°C 的温度,利用焦耳-汤姆逊效应。这种冷却通过形成细胞内冰晶和破坏内皮细胞损伤导致的血流来导致细胞破坏,导致局部缺血和去血管化。将其与 CT 技术相结合,可以实现精确的肿瘤靶向,保护周围健康组织,并减少术后并发症。这篇综述报告了 CT 引导下冷冻消融术在肌肉骨骼肿瘤学中的应用的最重要文献,包括肉瘤、骨转移、骨和软组织良性原发性肿瘤,报告了冷冻消融术在肌肉骨骼系统中的成功率、复发率、并发症和技术方面,以最大限度地提高其成功率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4d1/10377811/a9cde3652a81/curroncol-30-00495-g001.jpg

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