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

  • Oncology
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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.

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Author information

Authors and Affiliations

  1. Department of Experimental Medicine, Division of Radiation Oncology and Radiobiology, S. Salvatore Hospital, University of L’Aquila, Medical School, Via Vetoio Coppito 2, 67100, L’Aquila, Italy

    M. Di Staso, G. L. Gravina, P. Bonfili, F. Marampon, L. Di Nicola, P. Franzese & V. Tombolini

  2. Department of Experimental Medicine, Division of Radiology, S. Salvatore Hospital, L’Aquila, University of L’Aquila, Medical School, Via Vetoio Coppito 2, 67100, L’Aquila, Italy

    L. Zugaro, A. Conchiglia, M. Gallucci & C. Masciocchi

  3. Department of Pathology, S. Salvatore Hospital, L’Aquila, Italy

    L. Ventura

  4. Department of Experimental Medicine, Division of Radiation Oncology and Radiobiology, University of L’Aquila, L’Aquila, Italy

    G. L. Gravina

Authors
  1. M. Di Staso
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  2. L. Zugaro
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  3. G. L. Gravina
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  4. P. Bonfili
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  5. F. Marampon
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  6. L. Di Nicola
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  7. A. Conchiglia
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  8. L. Ventura
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  9. P. Franzese
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  10. M. Gallucci
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  11. C. Masciocchi
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  12. V. Tombolini
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Corresponding author

Correspondence to G. L. Gravina.

Additional information

M. Di Staso, L. Zugaro and G. L. Gravina have Equal Contribution

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Di Staso, M., Zugaro, L., Gravina, G.L. et al. A feasibility study of percutaneous radiofrequency ablation followed by radiotherapy in the management of painful osteolytic bone metastases. Eur Radiol 21, 2004–2010 (2011). https://doi.org/10.1007/s00330-011-2133-3

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  • DOI: https://doi.org/10.1007/s00330-011-2133-3

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