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European Radiology

, Volume 21, Issue 9, pp 2004–2010 | Cite as

A feasibility study of percutaneous radiofrequency ablation followed by radiotherapy in the management of painful osteolytic bone metastases

  • M. Di Staso
  • L. Zugaro
  • G. L. Gravina
  • P. Bonfili
  • F. Marampon
  • L. Di Nicola
  • A. Conchiglia
  • L. Ventura
  • P. Franzese
  • M. Gallucci
  • C. Masciocchi
  • V. Tombolini
Oncology

Abstract

Objectives

To determine whether Radiofrequency Ablation (RFA) followed by Radiotherapy (RT) (RFA-RT) produces better palliation in terms of pain than RT alone in patients with osteolytic bone metastases.

Methods

Patients with solitary bone metastases and a pain score of least 5 or more on the VAS scale were selected. Fifteen patients were treated with RFA-RT (20 Gy delivered in 5 fractions of 4 Gy over 1 week) and were compared with a matched group (30 subjects) treated by RT.

Results

A complete response in terms of pain relief at 12 weeks was documented in 16.6% (5/30) and 53.3% (8/15) of the subjects treated by RT or RFA-RT, respectively (p = 0.027). The overall response rate at 12 weeks was 93.3% (14 patients) in the group treated by RFA-RT and 59.9% (18 patients) in the group treated by RT (p = 0.048). Although recurrent pain was documented more frequently after RT (26.6%) than after RFA-RT (6.7%) the difference did not reach statistical significance. The morbidity related to RT did not significantly differ when this treatment was associated with RFA.

Conclusions

Our results suggest that RFA-RT is safe and more effective than RT. The findings described here should serve as a framework around which to design future clinical trials.

Keywords

Morbidity Palliative care Radiotherapy Radiofrequency ablation Skeletal metastases 

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Copyright information

© European Society of Radiology 2011

Authors and Affiliations

  • M. Di Staso
    • 1
  • L. Zugaro
    • 2
  • G. L. Gravina
    • 1
    • 4
  • P. Bonfili
    • 1
  • F. Marampon
    • 1
  • L. Di Nicola
    • 1
  • A. Conchiglia
    • 2
  • L. Ventura
    • 3
  • P. Franzese
    • 1
  • M. Gallucci
    • 2
  • C. Masciocchi
    • 2
  • V. Tombolini
    • 1
  1. 1.Department of Experimental Medicine, Division of Radiation Oncology and Radiobiology, S. Salvatore HospitalUniversity of L’Aquila, Medical SchoolL’AquilaItaly
  2. 2.Department of Experimental Medicine, Division of Radiology, S. Salvatore Hospital, L’AquilaUniversity of L’Aquila, Medical SchoolL’AquilaItaly
  3. 3.Department of PathologyS. Salvatore HospitalL’AquilaItaly
  4. 4.Department of Experimental Medicine, Division of Radiation Oncology and RadiobiologyUniversity of L’AquilaL’AquilaItaly

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