Gangi A, Dietemann J L, Schultz A, Mortazavi R, Jeung M Y, Roy C
Department of Radiology B, University Hospital of Strasbourg, France.
Radiographics. 1996 Nov;16(6):1289-304; discussion 1304-6. doi: 10.1148/radiographics.16.6.8946536.
Reduction of pain without systematic side effects can be achieved in advanced stages of cancer with precise percutaneous techniques guided with computed tomography (CT). CT guidance allows exact needle positioning, reducing complications and improving the results. Regional analgesia with neurolytic block (neurolysis) is achieved by injection of alcohol or phenol and involves intentional destruction of a nerve or nerves to interrupt nociceptive pathways for weeks or months. Percutaneous alcoholization of bone metastasis is indicated in patients with painful, severe, osteolytic bone metastasis if conventional anticancer therapy is ineffective and high doses of opiates are necessary to control pain and when rapid pain relief is necessary. Bone packing with acrylic glue (methyl methacrylate) is used to prevent pathologic fractures and pain in patients with vertebral body tumors and acetabular metastasis. With these techniques, the radiologist is able to play an active role in pain management and in improving the quality of life of patients with malignancies.
在癌症晚期，采用计算机断层扫描（CT）引导下的精确经皮技术，可实现减轻疼痛且无系统性副作用。CT引导可实现精确的针定位，减少并发症并改善治疗效果。通过注射酒精或苯酚进行神经溶解阻滞（神经松解）的区域镇痛，涉及故意破坏一条或多条神经，以中断伤害性通路数周或数月。如果传统抗癌治疗无效且需要高剂量阿片类药物来控制疼痛以及需要快速缓解疼痛时，对于疼痛严重的溶骨性骨转移患者，可进行经皮酒精消融骨转移灶。使用丙烯酸胶水（甲基丙烯酸甲酯）进行骨填充，以预防椎体肿瘤和髋臼转移患者的病理性骨折和疼痛。通过这些技术，放射科医生能够在疼痛管理以及改善恶性肿瘤患者的生活质量方面发挥积极作用。
