CT导向下骨盆肿瘤的射频消融治疗

CT guided radio frequency ablation as a treatment of pelvis tumor

目的探讨CT导向下射频消融技术在治疗骨盆肿瘤中的意义。方法收集中山大学附属肿瘤医院医学影像与介入中心2003年3月至2007年8月治疗的19例骨盆肿瘤患者，其中男11例、女8例，年龄25～49岁，中位年龄37岁。骨巨细胞瘤2例，尤文氏肉瘤2例，恶性纤维组织细胞瘤3例，肺癌骨盆转移4例，鼻咽癌骨盆转移4例，肝癌骨盆转移2例，乳腺癌骨盆转移2例。肿瘤最大长径为5．4～9．0cm，平均6．2cm。肿瘤生长部位按Enneking等提出的骨盆肿瘤分类方法，TypeⅠ型9例，TypeⅢ型4例，TypeⅣ型6例。患者主要临床症状为疼痛，按患者主诉疼痛程度分级法（VRS法）分级，轻度疼痛3例，中度疼痛8例，重度疼痛8例。根据肿瘤组织的情况，选用单极或多极消融设备。治疗时采用CT引导定位，穿刺前常规扫描定位，根据肿瘤的大小及位置，选定最佳层面进针。根据患者肿瘤大小决定消融时间，治疗时间为5—15min，必要时行叠加治疗。结果疼痛完全缓解10例（10／19），部分缓解8例（8／19），轻度缓解1例（1／19）。影像学评价完全缓解（CR）10例，部分缓解（PR）7例，稳定2例。结论CT导向下射频消融技术是治疗骨盆肿瘤的有效方法。

Objective To explore the clinical value of CT guided radio frequency ablation in the treatment of pelvis tumor. Methods 11 males and 8 females ranging from 25 to 49 years old （ average 37 ） were enrolled in this study, all the 19 patients were suffering from pelvis tumor including giant cell tumor of bone（2/19）, Ewing＇ s sarcoma （ 2/19 ）, malignant fibrous histiocytoma （ 3/19 ） and metastatic diseases （12/19）. The average diameter of the lesions were 6. 2 cm. The predominant clinical symptom of the patients was pain in the local region. All the patients were treated by CT guided radio frequency ablation. Single pole or mutiple poles radio frequency ablation device was used according to the characteristics of the tumor tissue. Time of therapy was 5 - 15 min. Superposition was peroformed if necessary. Results All the patients received PET- CT scan or enhanced CT scan 1 month after the treatment, CR, PR was seen in 10 and 7 cases respectively. Total pain relief was seen in 10 patients, partial pain relief was seen in 8 patients, and gently pain relief was seen in 1 patient. Conclusion CT guided CT guided radio frequency ablation is an effective methods in the treatment of pelvis tumor.