根據(jù)5月7日在線發(fā)表在PAIN Practice上的綜述，冷凍消融可有效控制癌癥疼痛，且沒(méi)有很多副作用。

　　來(lái)自西班牙巴塞羅那的L'Hospitalet de Llobregat的Laura Ferrer-Mileo及其同事進(jìn)行了系統(tǒng)文獻(xiàn)回顧，以確定評(píng)估冷凍消融治療癌癥疼痛療效的文章。

　　納入了22項(xiàng)研究(共496名患者)，研究人員發(fā)現(xiàn)，冷凍消融后的24小時(shí)內(nèi)平均疼痛評(píng)分降低了62.5%，3個(gè)月時(shí)降低70%，6個(gè)月時(shí)降低80.9%。相對(duì)地，冷凍消融與四周后的生活質(zhì)量提高44.2%、八周后改善59.6%相關(guān)。在24小時(shí)內(nèi)，阿片類藥物的需求減少了75%，在三個(gè)月減少了61.7%。冷凍消融與放療、或椎體成形術(shù)或雙膦酸鹽的組合似乎優(yōu)于單獨(dú)的冷凍消融。任何研究都沒(méi)有報(bào)告致命的并發(fā)癥。

　　作者寫(xiě)道：“需要國(guó)際標(biāo)準(zhǔn)來(lái)標(biāo)準(zhǔn)化用于評(píng)估疼痛和治療反應(yīng)的措施。”

　　原文鏈接

　　Efficacy of cryoablation to control cancer pain. A systematic review

　　Laura Ferrer‐Mileo,Ana Isabel Luque Blanco,Jesús González‐Barboteo

　　Context

　　The use of opioids to control cancer pain could be insufficient. Interventional techniques such as a cryoablation have emerged as alternatives to opioids.

　　Objectives

　　To summarize the current scientific evidence on the use of cryoablation to control cancer pain.

　　Methods

　　A systematic search of the Scopus, Pubmed, and Cochrane databases was performed. All articles published before December 31, 2015 whose title or abstract specified cancer pain control as endpoint were selected. Articles without abstract and all non‐systematic reviews were excluded.

　　Results

　　22 articles were included: one randomized clinical trial (RCT); two non‐RCTs; one ambispective study; 9 retrospective studies; two non‐specified cohort studies; three case series and four case reports. 496 patients with 580 lesions were treated. Lung cancer was the most common primary tumour. 82.8% of the metastases were bone metastases, with or without soft tissue involvement. Cryoablation decreased mean pain scores by 62.5% at 24 hours post‐cryoablation, by 70% at 3 months, and by 80.9% at 6 months. Cryoablation was associated with a 44.2% improvement in quality of life (QoL) after 4 weeks and a 59.6% at 8 weeks. The need for opioids decreased by 75% at 24 h and by 61.7% at 3 months. Cryoablation in combination with radiotherapy, vertebroplasty or bisphosphonates appears to be better than cryoablation alone. Complications were highly variable among the studies, but no fatal complications were reported.

　　Conclusions

　　Cryoablation is effective in controlling cancer pain without relevant side effects. However, more studies are needed to confirm these results.

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