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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 assess the safety and local efficacy of CT-guided conformal cryosurgery in the treatment of osteolytic metastases. Methods Totally 36 patients with osteolytic bone metastases (51 lesions) were collected in our hospital. All patients had a definite pathological diagnosis and no pain relief after 2 months of treatment with bisphosphonates. Patients underwent CT-guided conformal cryosurgery. Immediate CT scans were performed after 2 months to evaluate the effect of CT and observe the presence or absence of complications. Visual acuity score system (VAS) pain scores were analyzed preoperatively, 1 week postoperatively, and 2 months postoperatively. Results All patients successfully completed the operation without serious complications. No local recurrence was found in 2 months after treatment, and no enhancement was seen in enhanced CT; 2 cases of newly diagnosed metastatic lesions. The VAS pain scores of patients in one week after operation were significantly lower than those before operation (4.18 ± 0.82) and 2 months (2.36 ± 1.01) respectively (all P <0.05). Conclusion The CT-guided conformal cryosurgical treatment of osteolytic metastatic tumor has significant local efficacy and high safety.