Klinische Aspekte zur Problematik der Wirbelkörpermetastasen, Möglichkeiten moderner Behandlungsmethoden unter besonderer Berücksichtigung der Radiofrequenzablation

Zusammenfassung Von 100 000 Menschen in Deutschland bekommen statistisch berechnet 441 Männer und 350 Frauen einen Tumor. Bei etwa 50 bis 80 % der Patienten mit Mamma- oder Prostatakarzinom werden Knochenmetastasen registriert, womit u. a. ein hohes Risiko für pathologische Frakturen und weitere belastende Krankheiten verbunden ist. Die Diagnostik der Knochenmetastasen erfolgt durch konventionelle Röntgentechnik, CT, MRT und besonders mithilfe der Skelettszintigrafie. Für die Therapie bieten sich als Medikamente Bisphosphonate, Antihormone und Chemotherapeutika an. Weiterhin werden Strahlentherapie, Radionuklide, chirurgische Eingriffe und ablative Verfahren angewandt. Zu den neueren technischen Verfahren gehört das STAR™-Tumorablationssystem, wobei minimalinvasiv eine Elektrode zum tumorösen Gewebe in den Wirbelkörper eingeführt wird. Das System gewährleistet eine präzise Steuerung und damit eine gezielte Ablation. Mehrere Publikationen und Berichte über eine kombinierte Anwendung belegen die synergistische Effektivität von RFA und Radiofrequenzkyphoplastie.

[1]  Oliver Beuing,et al.  Bipolar radiofrequency ablation of spinal tumors: predictability, safety and outcome. , 2014, The spine journal : official journal of the North American Spine Society.

[2]  K. Modaressi,et al.  Knochenmetastasen – Abklärung und Therapie , 2013 .

[3]  B. Georgy,et al.  Image-guided targeted radiofrequency ablation (t-RFA) of spinal tumors using a novel bipolar navigational device: multicenter initial clinical experience , 2013 .

[4]  Thomas Wiegel,et al.  Guidelines on Prostate Cancer , 2013 .

[5]  B. Wiedenhöfer,et al.  „Wirbelkörperstabilität“ im spinalen Metastasenmanagement , 2012, Der Orthopäde.

[6]  E. McCloskey,et al.  Bisphosphonates in oncology. , 2011, Bone.

[7]  C. Masciocchi,et al.  A feasibility study of percutaneous radiofrequency ablation followed by radiotherapy in the management of painful osteolytic bone metastases , 2011, European Radiology.

[8]  M. Scheper,et al.  Zoledronic acid directly suppresses cell proliferation and induces apoptosis in highly tumorigenic prostate and breast cancers , 2011, Journal of carcinogenesis.

[9]  W. Fiedler,et al.  Microcirculation of secondary bone tumors in vivo: The impact of minor surgery at a distal site , 2010, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[10]  M. Callstrom,et al.  Image-guided percutaneous ablation of bone and soft tissue tumors. , 2010, Seminars in interventional radiology.

[11]  M. Mühlbauer Die chirurgische Behandlung spinaler Metastasen , 2010 .

[12]  G. Maccauro,et al.  Jaw osteonecrosis related to bisphosphonate treatment of bone metastasis. , 2010, Journal of biological regulators and homeostatic agents.

[13]  A. Karantanas,et al.  Treatment of pathologic spinal fractures with combined radiofrequency ablation and balloon kyphoplasty , 2009, World journal of surgical oncology.

[14]  Y. M. van der Linden,et al.  The treatment of bone metastasis with highly conformal radiation therapy: a brave new world or a costly mistake? , 2009, Clinical oncology (Royal College of Radiologists (Great Britain)).

[15]  P. Munk,et al.  Combined cementoplasty and radiofrequency ablation in the treatment of painful neoplastic lesions of bone. , 2009, Journal of vascular and interventional radiology : JVIR.

[16]  M. Mack,et al.  Prospective pilot-study of combined bipolar radiofrequency ablation and application of bone cement in bone metastases. , 2009, Anticancer research.

[17]  F. Ronza,et al.  Radiofrequency ablation of bone metastases induces long-lasting palliation in patients with untreatable cancer. , 2008, Singapore medical journal.

[18]  M. Reiser,et al.  Radiofrequency ablation in combination with osteoplasty in the treatment of painful metastatic bone disease. , 2008, Journal of vascular and interventional radiology : JVIR.

[19]  C. Parker,et al.  Bone-targeted radium-223 in symptomatic, hormone-refractory prostate cancer: a randomised, multicentre, placebo-controlled phase II study. , 2007, The Lancet. Oncology.

[20]  P. Warde,et al.  Pain flare in patients with bone metastases after palliative radiotherapy—a nested randomized control trial , 2007, Supportive Care in Cancer.

[21]  S. Nilsson,et al.  High-Linear Energy Transfer Irradiation Targeted to Skeletal Metastases by the α-Emitter 223Ra: Adjuvant or Alternative to Conventional Modalities? , 2006, Clinical Cancer Research.

[22]  Afshin Gangi,et al.  Saline-infused bipolar radiofrequency ablation of high-risk spinal and paraspinal neoplasms. , 2006, AJR. American journal of roentgenology.

[23]  H. Seegenschmiedt,et al.  Therapie von Skelettmetastasen , 2006 .

[24]  Y. Shomura,et al.  Clinical Assessment of Percutaneous Radiofrequency Ablation for Painful Metastatic Bone Tumors , 2006, CardioVascular and Interventional Radiology.

[25]  N. Toyota,et al.  Radiofrequency Ablation Therapy Combined with Cementoplasty for Painful Bone Metastases: Initial Experience , 2005, CardioVascular and Interventional Radiology.

[26]  W W Mayo-Smith,et al.  Radiofrequency ablation of bony metastatic disease. , 2004, Clinical radiology.

[27]  G. Roodman Mechanisms of bone metastasis. , 2004, Discovery medicine.

[28]  Bradford J Wood,et al.  Percutaneous tumor ablation with radiofrequency , 2002, Cancer.

[29]  D. Grönemeyer,et al.  Image‐Guided Radiofrequency Ablation of Spinal Tumors: Preliminary Experience with an Expandable Array Electrode , 2002, Cancer journal.

[30]  C. Krettek,et al.  Diagnostik und Therapie von Knochenmetastasen , 2001, Der Unfallchirurg.

[31]  P W Mantyh,et al.  Bone cancer pain: from mechanism to model to therapy. , 2000, Pain medicine.

[32]  L. Dogliotti,et al.  Incidence of skeletal complications in patients with bone metastatic prostate cancer and hormone refractory disease: predictive role of bone resorption and formation markers evaluated at baseline. , 2000, The Journal of urology.

[33]  S. Magnuson,et al.  Endothelin-1 production and decreased endothelin B receptor expression in advanced prostate cancer. , 1996, Cancer research.

[34]  R. L. Carter Patterns and mechanisms of bone metastases. , 1985, Journal of the Royal Society of Medicine.