CT引导下适形冷冻消融治疗溶骨性转移瘤

CT-guided conformal cryoablation in treatment of lytic bone metastases

目的评估CT引导下适形冷冻消融治疗溶骨性转移瘤的安全性及局部疗效。方法收集在我院就诊的溶骨性骨转移瘤患者36例(共51处病灶),所有患者均有明确的病理诊断且经双膦酸盐类药物治疗2个月后疼痛无缓解。患者均接受CT引导下适形冷冻消融治疗,并于治疗后即刻、2个月后分别行增强CT检查以评估治疗效果及观察有无并发症。分析患者在术前、术后1周及术后2个月的视觉模拟评分系统(VAS)疼痛评分结果。结果所有患者顺利完成手术,未出现严重并发症。治疗后2个月均未见局部复发、增强CT均未见强化;2例患者出现新发转移灶。患者术后1周[(4.18±0.82)分]及2个月[(2.36±1.01)分]VAS疼痛评分均较术前[(7.13±1.55)分]下降(P均<0.05)。结论 CT引导下适形冷冻治疗溶骨性转移瘤局部疗效显著、安全性较高。

Objective To evaluate the safety and local efficacy of CT-guided conformal cryoablation in treatment of patients with lyric metastatic lesions of bone. Methods Totally 36 patients （51 lesions） with osteolytic metastases who had pathological diagnosis and no response to bisphosphonates treatment were enrolled. All patients were performed CT-guided conformal cryoahlation, and underwent contrast CT scans immediately and 2 months after operation to evaluate treatment outcome and complications. Patient response was measured with VAS before the procedure and 1 week, 2 months after operation. Results All patients completed the operation successfully and had no serious complications. There was no local recurrence in 2 months after operation and the lesions appeared no enhancement on the follow up contrast CT images. But new metastatic lesions were found in 2 patients. Compared with those before treatment （7. 13± 1.55）, the scores for pain decreased 1 week （4.18±0.82） and 2 months （2.36±1.01） after treatment （both P〈0.05）. Conclusion CT-guided conformal cryoahlation is a safe and local effective method to treat lytic bone metastases.