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Combined Microwave Ablation and Cementoplasty in Patients with Painful Bone Metastases at High Risk of Fracture

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Abstract

Purpose

To retrospectively evaluate the effectiveness of computed tomography-guided percutaneous microwave ablation (MWA) and cementoplasty in patients with painful bone metastases at high risk of fracture.

Materials and Methods

Thirty-five patients with 37 metastatic bone lesions underwent computed tomography-guided MWA combined with cementoplasty (polymethylmethacrylate injection). Vertebrae, femur, and acetabulum were the intervention sites and the primary end point was pain relief. Pain severity was estimated by visual analog scale (VAS) before treatment; 1 week post-treatment; and 1, 6, and 12 months post-treatment. Functional outcome was assessed by improved patient walking ability. Radiological evaluation was performed at baseline and 3 and 12 months post-procedure.

Results

In all patients, pain reduction occurred from the first week after treatment. The mean reduction in the VAS score was 84, 90, 90 % at week 1, month 1, and month 6, respectively. Improved walking ability occurred in 100 and 98 % of cases at the 1- and 6-month functional outcome evaluations, respectively. At the 1-year evaluation, 25 patients were alive, and 10 patients (28 %) had died because of widespread disease. The mean reduction in the VAS score and improvement in surviving patients’ walking ability were 90 and 100 %, respectively. No patients showed evidence of local tumor recurrence or progression and pathological fracture in the treated sites.

Conclusion

Our results suggest that MWA combined with osteoplasty is safe and effective when treating painful bone metastases at high risk of fracture. The number of surviving patients at the 1-year evaluation confirms the need for an effective and long-lasting treatment.

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Conflict of interest

All of the authors declare that they have no conflicts of interest.

Ethical standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Authors and Affiliations

  1. Division of Interventional Radiology, Department of Oncological Radiology, Ocological Hospital “A. Businco”, Regional Referral Center for Oncologic Diseases, 09100, Cagliari, Italy

    Claudio Pusceddu & Nicola Ballicu

  2. Department of Oncological Radiology, Oncological Hospital “A. Businco”, Regional Referral Center for Oncological Diseases, 09100, Cagliari, Italy

    Barbara Sotgia, Rosa Maria Fele & Luca Melis

Authors
  1. Claudio Pusceddu
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  2. Barbara Sotgia
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  3. Rosa Maria Fele
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  4. Nicola Ballicu
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  5. Luca Melis
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Corresponding author

Correspondence to Claudio Pusceddu.

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Pusceddu, C., Sotgia, B., Fele, R.M. et al. Combined Microwave Ablation and Cementoplasty in Patients with Painful Bone Metastases at High Risk of Fracture. Cardiovasc Intervent Radiol 39, 74–80 (2016). https://doi.org/10.1007/s00270-015-1151-y

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  • DOI: https://doi.org/10.1007/s00270-015-1151-y

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