ABSTRACT
We present our experience of the treatment of bone tumors with radiofrequency thermal ablation (RFTA). Over the past 4 years, we have treated 26 cases (22 benign and 4 malignant) using CT-guided RFTA. RFTA was the sole treatment in 19 cases and was combined with percutaneous cementation during the same session in the remaining seven cases. Our approach to the tumors was simplified, using a single point of entrance for both RFTA and percutaneous osteoplasty. In the benign cases, clinical success was defined as resolution of pain within 1 month of the procedure and no recurrence during the follow-up period. It was achieved in 19 out of the 21 patients in which curative treatment was attempted. The two non-resolved cases were a patient with osteoid osteoma who developed a symptomatic bone infarct after a symptom-free period of 2 months and another with femoral diaphysis osteoblastoma who suffered a pathological fracture after 8 months without symptoms. The procedure was considered clinically successful in the five cases (4 malign and 1 benign) in which palliative treatment was attempted, because there was a mean (±SD) reduction in visual analogue scale (VAS) pain score from 9.0±0.4 before the procedure to <4 during the follow-up period.
Subject(s)
Bone Neoplasms/diagnostic imaging , Bone Neoplasms/surgery , Catheter Ablation/methods , Surgery, Computer-Assisted/methods , Tomography, X-Ray Computed/methods , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Treatment OutcomeABSTRACT
La xerostomía es la sensación subjetiva que el paciente autopercibe ante la escasez o carencia absoluta de saliva en la cavidad oral. También denominada a sialorrea o boca seca, en ningún caso constituye una entidad clínica por sí misma, sino más bien una manifestación de la disfunción de su aparato glandular. Son múltiples las causas que en la actualidad conocemos como originantes de este síntoma. Entre ellas encontramos la diabetes mellitus, el síndrome de Sjögren primario secundario con origen autoinmune, uso de ciertos fármacos entre los que destaca el grupo de los quimioterápicos, así como el empleo de tratamientos basados en la aplicación de radiaciones ionizantes. Por lo general, y a pesar del gran disconfort que origina en el paciente que la padece, la xerostomíano ha ocupado un puesto demasiado importante en la investigación dada su consideración de efecto o síntoma secundario. Sin embargo, el aumento en la supervivencia hace que muchos pacientes, entre ellos los enfermos de cáncer, vean en este síntoma un potencial enemigo que merma a diario su calidad de vida. Nuestro objetivo en esta revisión es ofrecer una actualización sobre los aspectos fisiopatológicos de la misma, así como de los diferentes procedimientos existentes en la actualidad para su diagnóstico y abordaje clínico (AU)
Xerostomia is a condition in which the patient perceives a scarcity or total lack of saliva in his/hermouth. Also called dry mouth, it is not a disease in itself, but rather a direct manifestation of glandulardys function. As such, it may have a wide range of causes. For example, xerostomia maybe a symptom of an underlying disease such as diabetes mellitus or primary and secondary Sjögren syndrome, which affects the auto-immune system. It can also be caused by certain medications, especially chemotherapy drugs or treatments which apply ionizing radiation (radiation therapy).Generally speaking, and despite the obvious discomfort suffered by the patient, xerostomia has not been the focus of much research because it has always been regarded as a secondary symptom or effect. However, due to increased survival rates, many patients (especially cancer survivors) perceive it as a potential enemy that significantly lowers their quality of life. The aim of this review is to provide an update of the physiopathological aspects of this condition as well as the different procedures presently used for its diagnosis and clinical management (AU)
