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RFA von Tumoren des Knochens und der Weichteile

RFA of osseous and soft tissue tumors

  • Thermotherapie
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Zusammenfassung

Die Radiofrequenzablation (RFA) von primären oder sekundären Lebertumoren ist eine vielversprechende und sich schnell weiterentwickelnde Technik, die sich in den letzten Jahren bei der Behandlung von Lebermalignomen zunehmend etabliert hat. Während die RFA schon seit längerem erfolgreich für die Behandlung von Osteoidosteomen eingesetzt wird, findet sie ein neues Einsatzgebiet in der minimal-invasiven Therapie fokal begrenzter, maligner Tumoren des Knochens und der Weichteile. Technik, Indikationen, Komplikationen und erste Ergebnisse der RFA von Knochen- und Weichteiltumoren werden vorgestellt.

Die Indikation zur RFA von ossären Metastasen oder Weichteiltumoren muss sehr sorgfältig und kritisch gestellt werden. Bei Patienten mit metastasierter Tumorerkrankung und Versagen bzw. schlechtem Ansprechen der systemischen Chemotherapie oder der Bestrahlung wird die Frage nach alternativen, palliativen Therapiekonzepten aufgeworfen. Die RFA kann in diesem selektionierten Patientenkollektiv meist bei geringer Morbidität signifikant zur Verbesserung der Lebensqualität beitragen. Dabei ist die RFA von ossären Metastasen oder Weichteiltumoren meist als ein palliatives Therapiekonzept anzusehen. Eigene Erfahrungen und Mitteilungen in der aktuellen Literatur belegen signifikante Erfolge bei der Verbesserung der Lebensqualität der behandelten Patienten.

Aufgrund ihres hohen technischen und klinischen Erfolgs und niedrigen Komplikationsrate kann die RFA deshalb als minimal-invasive, palliative Behandlungsalternative bei Patienten gelten, die chirurgisch nicht behandelt werden können oder die auf eine systemische Chemotherapie nicht ansprechen.

Abstract

Radiofrequency ablation (RFA) of primary and secondary liver malignancies is a promising and rapidly evolving technique, which increasingly gains importance. A new field of RFA is the minimal invasive therapy of osseous and soft tissue tumors. In the management of osteoid-osteoma, RFA is a well established treatment option. Basic principles, indications, complications and results of RFA will be presented.

A careful evaluation of indications for RFA in osseous or soft tissue neoplasms is mandatory. In patients who are neither candidates for surgical tumor resection nor respond to chemotherapy, there is a need for alternative treatment options. In these preselected patients a substantial improvement in quality of life with low associated morbidity can be provided by RFA.

In malignancies of bone and soft-tissue tumors, RFA is a palliative treatment option. Therefore, the results can not be compared to those of surgical resection or chemotherapy which essentially are employed with curative intention. Our own experiences as well as data published in the literature indicate that RFA is a helpful tool in preserving patient’s quality of life.

The high technical and clinical success together with a low complication rate makes RFA of osseous and soft tissue neoplasms a valuable supportive tool for patients not referable for surgery or systemic therapy.

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Authors and Affiliations

  1. Institut für Klinische Radiologie, Klinikum Großhadern der Universität München

    T. F. Jakobs, R. T. Hoffmann, C. Vick, A. Wallnöfer, M. F. Reiser & T. K. Helmberger

  2. Institut für Klinische Radiologie, Klinikum Großhadern der Universität München, Marchioninistr. 15, 81377 , München

    T. F. Jakobs

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  1. T. F. Jakobs
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  2. R. T. Hoffmann
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  3. C. Vick
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  4. A. Wallnöfer
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  6. T. K. Helmberger
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Correspondence to T. F. Jakobs.

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Jakobs, T.F., Hoffmann, R.T., Vick, C. et al. RFA von Tumoren des Knochens und der Weichteile. Radiologe 44, 370–375 (2004). https://doi.org/10.1007/s00117-004-1030-z

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