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Management of Painful Pelvic Bone Metastasis of Renal Cell Carcinoma Using Embolization, Radio-frequency Ablation, and Cementoplasty: A Prospective Evaluation of Efficacy and Safety

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Abstract

Purpose

To measure the impact on pain relief and patient quality of life using embolization radio-frequency ablation and cementoplasty (ERC) for local combination therapeutic management of painful pelvic bone metastasis of renal cell carcinoma (RCC).

Materials and Methods

This prospective monocentric registry was approved by our Local Institutional Review Board. Between January 2008 and January 2013, all consecutive patients who fully met the inclusion criteria were enrolled in the ERC-procedure prospective registry. They were assigned to follow-up at discharge and again at 1 and 6 months. Efficacy was evaluated using a pain visual analog scale (VAS), and narcotic consumption and quality of life were assessed using the Brief Pain Inventory questionnaire.

Results

Fifty-two patients were enrolled, among whom 58 lesions were treated. Technical success was obtained in all procedures. The median VAS score decreased from 7 ± 1.4 (ranges 5–10) at baseline to 3 ± 1.5 (ranges 0–6) at discharge, 2 ± 1.5 (ranges 0–5) at 1 month (p < 0.0001), and 2 ± 1.6 (ranges 0–5) at 6 months. In 28 patients (54 %), narcotic consumption was halved at discharge and halved in 40 (77 %) patients at 1 and 6 months compared with baseline. Five patients had complete pain relief at 1 month. A major improvement in quality of life, especially regarding mood and motion, was observed in all patients.

Conclusion

This specific approach to painful bone metastasis is efficient and safe and yields sustained results. The ERC procedure could be suggested for patients with RCC bone metastasis.

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Abbreviations

RCC:

Renal cell cancer

ECOGps:

Eastern Cooperative Oncology Group Performance Status

ASA:

American Society of Anesthesiologists

ERC:

Embolization radio-frequency ablation and cementoplasty

RFA:

Radio-Frequency Ablation

BPI:

Brief pain inventory

VAS:

Visual analog scale

PMMA:

Polymethyl methacrylate

PCA:

Patient control analgesia

MED:

Morphine-equivalent daily dose

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Acknowledgments

The authors acknowledge MingDe Lin PhD, for helpful comments and language editing.

Conflict of interest

All the authors have no conflict of interest to declare.

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Authors and Affiliations

  1. Faculté de Médecine, Université Paris Descartes - Sorbonne Paris Cité, Paris, France

    Olivier Pellerin, Jacques Medioni, Stéphane Oudard & Marc Sapoval

  2. Interventional Radiology Department, Assistance Publique - Hôpitaux de Paris, Georges Pompidou European Hospital, 20 rue Leblanc, 75908, Paris Cedex 15, France

    Olivier Pellerin, Carole Déan & Marc Sapoval

  3. Oncology Department, Assistance Publique - Hôpitaux de Paris, Georges Pompidou European Hospital, 20 rue Leblanc, 75908, Paris Cedex 15, France

    Jacques Medioni & Stéphane Oudard

  4. Anesthesia and Reanimation Care Department, Pain Management Center, Assistance Publique - Hôpitaux de Paris, Georges Pompidou European Hospital, 20 rue Leblanc, 75908, Paris Cedex 15, France

    Claire Vulser

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  1. Olivier Pellerin
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  2. Jacques Medioni
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Correspondence to Olivier Pellerin.

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Pellerin, O., Medioni, J., Vulser, C. et al. Management of Painful Pelvic Bone Metastasis of Renal Cell Carcinoma Using Embolization, Radio-frequency Ablation, and Cementoplasty: A Prospective Evaluation of Efficacy and Safety. Cardiovasc Intervent Radiol 37, 730–736 (2014). https://doi.org/10.1007/s00270-013-0740-x

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  • DOI: https://doi.org/10.1007/s00270-013-0740-x

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