Palliative pain relief and safety of percutaneous radiofrequency ablation combined with cement injection for bone metastasis
To investigate the pain relief effect and safety of percutaneous radiofrequency ablation (RFA) with a multitined electrode combined with cement injection in patients with painful metastatic bone tumors.
Materials and methods
Sixteen patients with 34 osteolytic metastatic lesions were treated with RFA including 4 males and 12 females (age range 54-84 years). Thirteen patients with spinal metastases received additional cement injection. Medical imaging, a visual analogue scale (VAS) and the EORTC QLQ-C30 were performed to evaluate the metastatic lesion, pain and quality of life, respectively, before and after RFA and at follow-ups.
The RFA and/or vertebroplasty with cement injection were successful in all patients (100%). Except for one patient who had cement leakage, no intraprocedural complications occurred. After RFA, severe refractory pain was greatly relieved in all patients, with pretreatment VAS score of 8.1±1.4 significantly reduced to 5.5±1.1 at 24 h, 2.8±0.6 at one week and 1.4±0.8 at 6 months (P<0.01). The EORTC QLQ-C30 scale at one month demonstrated significant improvement (P<0.05) in the physical (P=0.03) and emotion function (P=0.003), global health status (P=0.002), pain (P=0.001) and insomnia (P=0.002). The analgesics were reduced after the procedure and stopped two months later in all patients, with greatly improved quality of life and no apparent pain. Followed up for 6-12 months, all patients remained alive with no recurrence of pain.
RFA with or without bone cement is safe and effective in the palliative treatment of pain caused by metastatic bone tumors.
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