[1]刘 勇,何仕诚,朱海东,等.CT引导下经皮骨成形术治疗骨盆溶骨性转移肿瘤[J].介入放射学杂志,2023,32(12):1197-1201.
 LIU Yong,HE Shicheng,ZHU Haidong,et al. CT-guided percutaneous osteoplasty for the treatment of osteolytic metastases of the pelvis[J].journal interventional radiology,2023,32(12):1197-1201.
点击复制

CT引导下经皮骨成形术治疗骨盆溶骨性转移肿瘤()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
32
期数:
2023年12
页码:
1197-1201
栏目:
非血管介入
出版日期:
2024-01-02

文章信息/Info

Title:
 CT-guided percutaneous osteoplasty for the treatment of osteolytic metastases of the pelvis
作者:
刘 勇 何仕诚 朱海东 方 文 杜瑞杰 郭金和 朱光宇 陈 荔 滕皋军
Author(s):
LIU Yong HE Shicheng ZHU Haidong FANG Wen DU Ruijie GUO Jinhe ZHU Guangyu CHEN Li TENG Gaojun.
Department of Interventional and Vascular Surgery, Affiliated Zhongda Hospital of Southeast University, Nanjing, Jiangsu Province 21009, China
关键词:
【关键词】 骨盆 转移瘤 溶骨性 经皮骨成形术 CT引导
文献标志码:
A
摘要:
【摘要】 目的 评价CT导引下经皮骨成形术(percutaneous osteoplasty,POP)治疗骨盆转移性肿瘤的临床疗效及安全性。方法 收集2011年10月至2021年12月东南大学附属中大医院应用CT引导下行POP治疗骨盆溶骨性转移瘤且随访资料完整的40例患者临床资料。采用视觉模拟量表(VAS)评价POP术后1周和1、3、6及12个月的临床疗效,并记录关节功能及止痛药物应用情况。比较术前和术后3、6、12个月骨盆肿瘤破坏范围的变化,评价肿瘤控制情况。根据随访12个月内局部病灶有无进展分为控制组与进展组,比较两组全身抗肿瘤治疗比例、病灶大小、骨水泥注入量以及骨水泥充填率。结果 40例患者57处病灶POP操作均成功,骨水泥注入量为(4.56±2.25) mL/处。40例患者POP前、术后1周、术后1个月、术后3个月VAS评分分别为(8.00±0.85)、(2.05±0.96)、(2.08±0.94)、(2.18±0.84)分,术前与术后1周比较,差异有统计学意义(P<0.01);37例患者术后6个月VAS评分为(2.35±0.54)分,28例患者术后12个月VAS评分为(2.43±0.79)分,术后1周与术后1、3、6和12个月比较,差异无统计学意义(均P>0.05);术前与术后比较,差异有统计学意义(F=316.3,P<0.01)。术后3、6和12个月的局部控制率分别为96.49%、85.19%、78.12%,差异有统计学意义(P=0.026)。控制组与进展组全身抗肿瘤治疗比例、病灶大小及骨水泥注入量差异均无统计学意义(均P>0.05)。两组骨水泥充填率为(81.26±9.17)% 比(68.40±12.98)%,差异有统计学意义(P<0.01)。结论 CT引导下POP治疗骨盆转移瘤操作安全、疗效显著,骨水泥可较长时间控制局部病灶进展。

参考文献/References:

[1] Macedo F, Ladeira K, Pinho F, et al. Bone metastases: an overview[J]. Oncol Rev, 2017, 11: 321.
[2] Tomasian A, Jennings JW. Bone metastases: state of the art in minimally invasive interventional oncology[J]. Radiographics, 2021, 41: 1475- 1492.
[3] Zhang JJ, Zhou Y, Hu HY, et al. Safety and efficacy of multilevel vertebroplasty for painful osteolytic spinal metastases: a single- centre experience[J]. Eur Radiol, 2017, 27: 3436- 3442.
[4] Tian Q, Cheng Y, Wu C. Percutaneous osteoplasty for extraspinal metastases[J]. J Interv Med, 2018, 1: 137- 142.
[5] Liu HF, Wu CG, Tian QH, et al. Application of percutaneous osteoplasty in treating pelvic bone metastases: efficacy and safety[J]. Cardiovasc Intervent Radiol, 2019, 42: 1738- 1744.
[6] Park JW, Lim HJ, Kang HG, et al. Percutaneous cementoplasty for the pelvis in bone metastasis: 12- year experience[J]. Ann Surg Oncol, 2022, 29: 1413- 1422.
[7] Enneking WF, Dunham WK. Resection and reconstruction for primary neoplasms involving the innominate bone[J]. J Bone Joint Surg Am, 1978, 60: 731- 746.
[8] 孙飞虎,何仕诚,朱海东,等. 骨水泥充填对椎体溶骨型转移肿瘤控制作用的CT评价[J]. 中华医学杂志, 2018, 98:2661- 2665.
[9] Costelloe CM, Chuang HH, Madewell JE, et al. Cancer response criteria and bone metastases: RECIST 1.1, MDA and PERCIST[J]. J Cancer, 2010, 1: 80- 92.
[10] Yan T, Zhao Z, Tang X, et al. Improving functional outcome and quality of life for patients with metastatic lesion of acetabulum undergoing cement augmentation[J]. Medicine, 2019, 98: e17029.
[11] Lee JH, Kim IY, Kim YD, et al. Navigation- guided percutaneous pelvic cementoplasty for metastatic bone pain: a case report[J]. Medicine, 2021, 100: e25521.
[12] 刘鹤飞,田庆华,易 飞,等. 经皮骨成形术在骨盆骨转移瘤治疗中的应用[J]. 介入放射学杂志, 2018, 27:936- 940.
[13] Moser TP, Onate M, Achour K, et al. Cementoplasty of pelvic bone metastases: systematic assessment of lesion filling and other factors that could affect the clinical outcomes[J]. Skeletal Radiol, 2019, 48: 1345- 1355.
[14] 史慧娟,倪才方,陈 珑,等. 影像学引导下经皮骨成形术治疗难治性疼痛性椎体外骨转移瘤[J].中国介入影像与治疗学,2020, 17:720- 723.
[15] Garnon J, Jennings JW, Meylheuc L, et al. Biomechanics of the osseous pelvis and its implication for consolidative treatments in interventional oncology[J]. Cardiovasc Intervent Radiol, 2020, 43: 1589- 1599.
[16] Roedel B, Clarencon F, Touraine S, et al. Has the percutaneous vertebroplasty a role to prevent progression or local recurrence in spinal metastases of breast cancer?[J]. J Neuroradiol, 2015, 42: 222- 228.
[17] Liu Z, Liang H, Sun W, et al. Risk factors for local bone destruction progression in palliative percutaneous vertebroplasty for vertebral metastases and the significance of bone cement filling rates[J]. Pain Physician, 2021, 24: E101- E109.
[18] Hesler MC, Buy X, Catena V, et al. Assessment of risk factors for occurrence or worsening of acetabular fracture following percutaneous cementoplasty of acetabulum malignancies[J]. Eur J Radiol, 2019, 120: 108694.

相似文献/References:

[1]王宏伟,何仕诚,滕皋军,等.经皮椎体成形术治疗椎体转移性肿瘤的疗效分析[J].介入放射学杂志,2010,(10):784.
 WANG Hong-wei,HE Shi-cheng,TENG Gao-jun,et al.Percutaneous vertebroplasty for the treatment of spinal metastasis: evaluation of the therapeutic efficacy[J].journal interventional radiology,2010,(12):784.
[2]王福安,王立富,王书祥,等. 血管内化疗栓塞术联合椎体成形术治疗椎体转移性肿瘤的临床应用分析[J].介入放射学杂志,2011,(12):1003.
 WANG Fu-an,WANG Li-fu,WANG Shu-xiang,et al.Intravascular chemoembolization combined with percutaneous vertebroplasty for the treatment of metastatic vertebral tumors: an analysis of its clinical application[J].journal interventional radiology,2011,(12):1003.
[3]李 杰,谢其根,王卫国,等.CT引导下125I粒子植入内照射治疗肝门部移性肿瘤11例[J].介入放射学杂志,2015,(11):969.
 LI Jie,XIE Qi- gen,WANG Wei- guo,et al.CT- guided 125I seed implantation brachytherapy for metastases at hepatic hilum: preliminary results of 11 cases[J].journal interventional radiology,2015,(12):969.
[4]刘鹤飞,田庆华,易 飞,等.经皮骨成形术在骨盆骨转移瘤治疗中的应用 [J].介入放射学杂志,2018,27(10):936.
 LIU Hefei,TIAN Qinghua,YI Fei,et al.Application of percutaneous osteoplasty in treating pelvic metastases[J].journal interventional radiology,2018,27(12):936.
[5]王 涛,刘鹤飞,田庆华,等.经皮骶正中入路骶骨成形术治疗多节段骶骨体转移瘤[J].介入放射学杂志,2019,28(12):1171.
 WANG Tao,LIU Hefei,TIAN Qinghua,et al.Percutaneous sacroplasty via interpedicular approach for painful sacral metastases involving multiple sacral vertebral bodies [J].journal interventional radiology,2019,28(12):1171.
[6]邵海燕,牟 凌,吴春根.“钢筋混凝土术”治疗股骨上段骨转移瘤围手术期中预见性护理的应用[J].介入放射学杂志,2021,30(08):828.
 SHAO Haiyan,MOU Ling,WU Chungen..Application of prospective nursing measures in perioperative period of “reinforced concrete operation” for proximal femoral metastases[J].journal interventional radiology,2021,30(12):828.

备注/Memo

备注/Memo:
(收稿日期:2023- 02- 15)
(本文编辑:新 宇)
更新日期/Last Update: 2024-01-02