放射治疗后联合射频消融和球囊后凸成形术治疗脊柱转移和相关疼痛。病例报告

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引用次数: 0

摘要

背景:脊柱是骨转移的常见部位。放射治疗一直是局灶性转移性脊柱肿瘤的标准治疗方法,尽管它已显示出减轻疼痛的能力,但它并不是对所有患者都有效,而且可能对患者的生活质量产生负面影响。使用射频消融(RFA)联合后凸成形术治疗脊柱转移性疼痛已被证明是安全有效的治疗脊柱转移性疼痛。我们报告一例使用骨cooltm RFA球囊后凸成形术治疗脊柱转移和疼痛。病例报告:一名65岁男性,有前列腺癌转移至L1椎体和慢性腰痛,多种药物治疗难治性。他之前曾因骨转移而接受放射治疗,并因前列腺特异性抗原下降而继续使用恩杂鲁胺治疗前列腺癌,随后进行血液学/肿瘤学检查。采用骨酷RFA球囊后凸成形术治疗患者疼痛及肿瘤转移。结论:据我们所知,目前还没有文献讨论上述所有治疗方法(RFA、后凸成形术/椎体成形术、放疗)的同时进行、治疗顺序、治疗顺序的益处和后果、疼痛缓解的时间和程度,以及辐射暴露的差异。本病例的结果为在放射治疗前进行射频消融和后凸成形术提供了临床依据,但需要进一步的研究来进一步阐明这种治疗的最佳方法。关键词:背痛,骨,癌症,后凸成形术,转移,放疗,射频消融,椎体成形术
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Combined Radiofrequency Ablation and Balloon Kyphoplasty Following Radiation Therapy for Spinal Metastases and Associated Pain. A Case Report
BACKGROUND: The spine is a common area of metastasis to the bone. Radiation therapy has been the standard treatment for focal metastatic spine tumors, and although it has shown an ability to reduce pain, it is not curative for all patients and can negatively impact a patient’s quality of life. Treating spinal metastatic pain with the use of radiofrequency ablation (RFA) in combination with kyphoplasty has been shown to be safe and effective in the treatment of spinal metastatic pain. We present a case of using balloon kyphoplasty with OsteoCoolTM RFA for treating both spinal metastasis and pain. CASE REPORT: A 65-year-old man with a history of prostate cancer presented with metastasis to the L1 vertebral body and chronic low back pain refractory to multimodal pharmacologic treatment. He previously had radiation therapy for this bone metastasis and was maintained on enzalutamide for prostate cancer with decreasing prostate-specific antigens followed by hematology/oncology. Balloon kyphoplasty with OsteoCool RFA was performed with resolution of the patient’s pain as well as the tumor metastasis. CONCLUSION: To our knowledge, there is no available literature discussing the administration of all the above (i.e., RFA, kyphoplasty/vertebroplasty, radiation) together, the sequence in which they are performed, the benefits and consequences of the treatment sequence, the time to and level of pain relief, and differences in radiation exposure. The results of this case provide a clinical rationale for performing RFA and kyphoplasty prior to radiation treatment, while further studies should be conducted to further elucidate the best administration of this treatment. KEY WORDS: Back pain, bone, cancer, kyphoplasty, metastasis, radiation, radiofrequency ablation, vertebroplasty
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