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Combination radiofrequency ablation and cementoplasty for palliative treatment of painful neoplastic bone metastasis: experience with 53 treated lesions in 36 patients

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Abstract

Objective

We report the safety and efficacy of combined radiofrequency ablation and cementoplasty in treating painful neoplastic bone lesions.

Materials and Methods

Fifty-three combined radiofrequency ablation and cementoplasty procedures were completed in 36 patients. Thirty-four vertebrae (20 lumbar, 14 thoracic), 14 acetabulae, 3 sacra, 1 pubic symphysis, and 1 humerus were treated. Patient age ranged from 34 to 81 years (mean 57.6 years, SD = 12.6). Primary malignancies included: 12 breast, 5 lung, 6 multiple myeloma, 2 prostate, 2 renal cell carcinoma, 1 synovial sarcoma, 1 endometrial, 1 oral squamous cell carcinoma, 1 lymphoma, 1 colon, 1 transitional cell carcinoma, 1 colorectal, 1 cholangiocarcinoma, and 1 pheochromocytoma. Primary neoplasm location, pain levels pre- and post-procedure (as assessed using the Visual Analog Scale), number of radiofrequency (RF) treatments and any extravasation were documented.

Results

Combined radiofrequency ablation (RFA) and cementoplasty procedures were performed with 100% technical success (53 out of 53). The mean pre-procedure and post-procedure pain, as measured by the Visual Analog Scale (VAS), was 7.2/10 and 3.4/10 respectively. Symptomatic complications included one case of self-resolving transient thermal sciatic neurapraxia following RFA and acetabuloplasty. Two cases of transient pain following epidural leaks during treatment of thoracic vertebrae and breast metastases also occurred. Non-symptomatic complications, from a variety of cases, included cement emboli to the lung, incidental, non-symptomatic leaks into the needle track, spinal canal, draining veins, disc spaces, and an intra-articular leak into the hip joint.

Conclusion

Combined RFA and cementoplasty appears to be safe, practical and effective in the palliative treatment of painful neoplastic lesions.

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Authors and Affiliations

  1. Department of Radiology, Vancouver General Hospital, University of British Columbia, 899 W 12th Avenue, Vancouver, BC, V52 1M9, Canada

    Michael David Lane, Huy B. Q. Le, Steven Lee, Casey Young, Manraj K. S. Heran & Peter L. Munk

  2. Department of Internal Medicine, Division of Rheumatology, Vancouver General Hospital, University of British Columbia, 899 W 12th Avenue, Vancouver, BC, V52, 1M9, Canada

    Maziar Badii

  3. Department of Orthopaedics, University of British Columbia, 899 W 12th Avenue, Vancouver, BC, V52 1M9, Canada

    Paul William Clarkson

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  1. Michael David Lane
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Correspondence to Peter L. Munk.

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Lane, M.D., Le, H.B.Q., Lee, S. et al. Combination radiofrequency ablation and cementoplasty for palliative treatment of painful neoplastic bone metastasis: experience with 53 treated lesions in 36 patients. Skeletal Radiol 40, 25–32 (2011). https://doi.org/10.1007/s00256-010-1010-5

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  • DOI: https://doi.org/10.1007/s00256-010-1010-5

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