CardioVascular and Interventional Radiology

, Volume 29, Issue 6, pp 1022–1026 | Cite as

Clinical Assessment of Percutaneous Radiofrequency Ablation for Painful Metastatic Bone Tumors

  • Hiroyuki Kojima
  • Noboru Tanigawa
  • Shuji Kariya
  • Atsushi Komemushi
  • Yuzo Shomura
  • Satoshi Sawada
CLINICAL INVESTIGATION

Abstract

Purpose

To investigate the pain-alleviating effects of radiofrequency ablation (RFA) on metastatic bone tumors in relation to tumor size, combined therapy, and percent tumor necrosis rate following RFA.

Methods

Subjects comprised 24 patients with 28 painful metastatic bone tumors. A 17G internally cooled electrode was inserted into the tumor for CT guidance and ablation was performed. Bone cement was injected following RFA for 4 tumors involving a weight-bearing bone, while 5 tumors were treated using combined RFA and external irradiation. Percent necrosis rate of the tumor was measured using contrast-enhanced computed tomography 1 week after RFA.

Results

Improvement in the visual analog scale (VAS) score was 4.6 ± 2.2 for large tumors (>5 cm, n = 12), 3.7 ± 1.8 for medium-sized tumors (3.1–5.0 cm, n = 11), and 3.5 ± 1.7 for small tumors (≤3 cm, n = 4), with no significant differences noted among tumor sizes. Improvement in the VAS score was 3.5 ± 1.3 for the 4 tumors in the RFA + bone cement group, 3.2 ± 1.9 for the 5 tumors in the RFA + radiation therapy group, and 4.8 ± 2.2 for the 18 tumors in the RFA group. No significant differences were identified between groups. The improvement in the VAS score was 3.8 ± 2.3, 4.0 ± 1.9, and 4.7 ± 2.6 in patients with tumor necrosis rates of 0–49%, 50–74%, and 75–100%, respectively. No significant association was observed among these three groups.

Conclusion

Percutaneous RFA therapy was effective in relieving pain due to metastatic bone tumors. No relationships appear to exist between initial response and tumor size, combined therapy, and percent tumor necrosis.

Keywords

Bone neoplasm Computed tomography (CT) guidance Metastases Radiofrequency ablation 

References

  1. 1.
    Mercadante S (1997) Malignant bone pain: Pathophysiology and treatment. Pain 69:1–18PubMedCrossRefGoogle Scholar
  2. 2.
    Nielsen OS, Munro AJ, Tannock IF (1991) Bone metastasis: Pathophysiology and management policy. J Clin Oncol 9:509–524PubMedGoogle Scholar
  3. 3.
    Saarto T, Janes R, Tenhunen M, et al. (2002) Palliative radiotherapy in the treatment of skeletal metastasis. Eur J Pain 6:323–330PubMedCrossRefGoogle Scholar
  4. 4.
    Poullsen HS, Nielsen OS, Klee M, et al. (1989) Palliative irradiation of bone metastasis. Cancer Treat Rev 16:41–48CrossRefGoogle Scholar
  5. 5.
    Dupuy DE, Goldberg SN (2001) Image-guided radiofrequency tumor ablation: Challenges and opportunities. Part II. J Vasc Interv Radiol 12:1135–1148Google Scholar
  6. 6.
    Neeman Z, Wood BJ (2002) Radiofrequency ablation beyond the liver. Tech Vasc Interv Radiol 5:156–163PubMedCrossRefGoogle Scholar
  7. 7.
    Poggi G, Gatti C, Melazzini M, et al. (2003) Percutaneous ultrasound-guided radiofrequency thermal ablation of malignant osteolyses. Anticancer Res 23:4977–4984PubMedGoogle Scholar
  8. 8.
    Goetz MP, Callstrom MR, Charboneau JW, et al. (2004) Percutaneous image-guided radiofrequency ablation of painful metastases involving bone: A multicenter study. J Clin Oncol 22:300–306PubMedCrossRefGoogle Scholar
  9. 9.
    Toyota N, Naito A, Kakizawa H, et al. (2005) Radiofrequency ablation therapy combined with cementoplasty for painful bone metastases: Initial experience. Cardiovasc Intervent Radiol 28:578–583PubMedCrossRefGoogle Scholar
  10. 10.
    Nakatsuka A, Yamakado K, Maeda M, et al. (2004) Radiofrequency ablation combined with bone cement injection for the treatment of bone malignancies. J Vasc Interv Radiol 15:707–712PubMedGoogle Scholar
  11. 11.
    Maruyama M, Asano T, Kenmochi T, et al. (2003) Radiofrequency ablation therapy for bone metastasis from hepatocellular carcinoma: Case report. Anticancer Res 23:2987–2900PubMedGoogle Scholar
  12. 12.
    Lokin JK, Mannes A, Berger A, et al. (2004) Palliation of soft tissue cancer pain with radiofrequency ablation. J Support Oncol 2:439–445Google Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Hiroyuki Kojima
    • 1
  • Noboru Tanigawa
    • 1
  • Shuji Kariya
    • 1
  • Atsushi Komemushi
    • 1
  • Yuzo Shomura
    • 1
  • Satoshi Sawada
    • 1
  1. 1.Department of RadiologyKansai Medical University Takii HospitalMoriguchiJapan

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