Percutaneous image-guided radiofrequency ablation of painful metastases involving bone: a multicenter study.
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.
Goetz
Matthew P
MP
Department of Oncology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Callstrom
Matthew R
MR
Charboneau
J William
JW
Farrell
Michael A
MA
Maus
Timothy P
TP
Welch
Timothy J
TJ
Wong
Gilbert Y
GY
Sloan
Jeff A
JA
Novotny
Paul J
PJ
Petersen
Ivy A
IA
Beres
Robert A
RA
Regge
Daniele
D
Capanna
Rodolfo
R
Saker
Mark B
MB
Grönemeyer
Dietrich H W
DH
Gevargez
Athour
A
Ahrar
Kamran
K
Choti
Michael A
MA
de Baere
Thierry J
TJ
Rubin
Joseph
J
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