title: Percutaneous image-guided radiofrequency ablation of painful metastases involving bone: a multicenter study.
abstract: OBJECTIVE
  Few options are available for pain relief in patients with bone metastases who fail standard treatments. We sought to determine the benefit of radiofrequency ablation (RFA) in providing pain relief for patients with refractory pain secondary to metastases involving bone.
  
  
  METHODS
  Thirty-one US and 12 European patients with painful osteolytic metastases involving bone were treated with image-guided RFA using a multitip needle. Treated patients had > or = 4/10 pain and had either failed or were poor candidates for standard treatments such as radiation or opioid analgesics. Using the Brief Pain Inventory-Short Form, worst pain intensity was the primary end point, with a 2-unit drop considered clinically significant.
  
  
  RESULTS
  Forty-three patients were treated (median follow-up, 16 weeks). Before RFA, the mean score for worst pain was 7.9 (range, 4/10 to 10/10). Four, 12, and 24 weeks following treatment, worst pain decreased to 4.5 (P <.0001), 3.0 (P <.0001), and 1.4 (P =.0005), respectively. Ninety-five percent (41 of 43 patients) experienced a decrease in pain that was considered clinically significant. Opioid usage significantly decreased at weeks 8 and 12. Adverse events were seen in 3 patients and included (1) a second-degree skin burn at the grounding pad site, (2) transient bowel and bladder incontinence following treatment of a metastasis involving the sacrum, and (3) a fracture of the acetabulum following RFA of an acetabular lesion.
  
  
  CONCLUSIONS
  RFA of painful osteolytic metastases provides significant pain relief for cancer patients who have failed standard treatments.
authors.affiliation: Department of Oncology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Goetz
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Callstrom
authors.forename: J William
authors.initials: JW
authors.lastname: Charboneau
authors.forename: Michael A
authors.initials: MA
authors.lastname: Farrell
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Maus
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Welch
authors.forename: Gilbert Y
authors.initials: GY
authors.lastname: Wong
authors.forename: Jeff A
authors.initials: JA
authors.lastname: Sloan
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Novotny
authors.forename: Ivy A
authors.initials: IA
authors.lastname: Petersen
authors.forename: Robert A
authors.initials: RA
authors.lastname: Beres
authors.forename: Daniele
authors.initials: D
authors.lastname: Regge
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Capanna
authors.forename: Mark B
authors.initials: MB
authors.lastname: Saker
authors.forename: Dietrich H W
authors.initials: DH
authors.lastname: Grönemeyer
authors.forename: Athour
authors.initials: A
authors.lastname: Gevargez
authors.forename: Kamran
authors.initials: K
authors.lastname: Ahrar
authors.forename: Michael A
authors.initials: MA
authors.lastname: Choti
authors.forename: Thierry J
authors.initials: TJ
authors.lastname: de Baere
authors.forename: Joseph
authors.initials: J
authors.lastname: Rubin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000150:complications / Q000556:secondary* / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010014:Osteolysis; D010146:Pain / Q000209:etiology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional