Percutaneous Image-Guided Ablation in the Treatment of Osseous Metastases from Non-small Cell Lung Cancer

  • Yuntong Ma
  • Adam N. Wallace
  • Saiama N. Waqar
  • Daniel Morgensztern
  • Thomas P. Madaelil
  • Anderanik Tomasian
  • Jack W. Jennings
Clinical Investigation
  • 188 Downloads

Abstract

Introduction

Percutaneous image-guided ablation is an emerging minimally invasive therapy for patients with metastatic bone disease for whom radiation therapy is ineffective or contraindicated. The purpose of this study was to examine the safety and efficacy of percutaneous ablation in achieving pain palliation and local tumor control of osseous metastases from non-small cell lung cancer (NSCLC).

Methods

A retrospective review was performed of 76 musculoskeletal metastases in 45 patients treated with percutaneous ablation. 63% (48/76) were treated with radiofrequency ablation (RFA), 35% (27/76) with cryoablation, and 1.3% (1/76) with microwave ablation (MWA). In 70% (53/76) of cases, associated cementoplasty was performed. Primary outcomes measured were pre- and post-procedure pain scores 4 weeks after treatment and local tumor control at 3-, 6-, and 12-month follow-up.

Results

Mean age of the cohort was 63.6 ± 9.5 years. Median tumor diameter was 3.60 cm (range 1.0–10.0 cm). Mean and median pain scores before treatment were 7.5 ± 2.3 and 8.0, respectively. Post-procedure, patients reported significantly decreased pain scores at 4 weeks (mean, 3.7 ± 3.5; median, 3.0; p < 0.00001). Radiographic local tumor control rates were 83% (35/42) at 3 months, 77% (23/30) at 6 months, and 68% (17/25) at 12 months after treatment. The overall complication rate was 2.6% (2/76).

Conclusion

Percutaneous tumor ablation is a well-tolerated, minimally invasive procedure associated with improving pain palliation and achieving local tumor control of osseous metastases from NSCLC.

Level of Evidence

Level 4, case series.

Keywords

NSCLC Osseous metastases Pain palliation Local tumor control Radiofrequency ablation Cryoablation Microwave ablation Cementoplasty 

Notes

Compliance with Ethical Standards

Conflict of interest

Jack W. Jennings is a paid consultant for Merit Medical Inc. and Medtronic. Anderanik Tomasian is a paid consultant for Medtronic. On behalf of the remaining authors, the corresponding author states that there is no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors. For this type of study, formal consent is not required.

Informed Consent

Informed consent was waived for retrospective study participation.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2017

Authors and Affiliations

  1. 1.Washington University School of MedicineSt. LouisUSA
  2. 2.Mallinckrodt Institute of RadiologyWashington University School of MedicineSt. LouisUSA
  3. 3.Division of Medical OncologyWashington University School of MedicineSt. LouisUSA
  4. 4.Department of Radiology, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesUSA

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