Percutaneous ultrasound-guided radiofrequency thermal ablation of malignant osteolyses.
Metastases are the most common neoplastic pathology involving the skeletal system. The hallmark of skeletal metastases is pain that often compromises the patient's quality of life. Radiotherapy, surgery and chemotherapy are the cornerstones of the treatment, but these techniques are not completely effective. Radiofrequency thermal ablation (RFA) may offer an alternative to conventional therapies for pain control. At present, the main field of application of RFA is the treatment of primary or secondary tumors of the liver but, recently, the technique has been effectively used to treat various other tumors in organs such as the prostate, kidney, lung, brain, pancreas and breast and to control pain caused by osteoid osteomas. Five patients with six painful bone metastases underwent RFA. The patients were three women and two men, aged 40-77 years (mean: 63.4). The radiofrequency system consists of an insulated 18-gauge needle electrode attached to a 500-kHz RF generator (Radionics, Burlington, Mass, USA). Four of our five patients rapidly obtained pain relief. One patient was completely pain free within 48 hours of the procedure and the control of pain persisted for 88 weeks. Another three patients obtained at least fifty percent pain reduction that lasted, on average, 12 weeks. Our preliminary results confirm that ultrasound-guided RFA is a simple and safe technique for treating painful superficial bone metastases.
Poggi
Guido
G
U.O. Oncologia II, IRCCS Fondazione S. Maugeri, Pavia, Italy. gpoggi@fsm.it
Gatti
Carlo
C
Melazzini
Mario
M
Bernardo
Giovanni
G
Strada
Mariarosa
M
Teragni
Cristina
C
Delmonte
Angelo
A
Tagliaferri
Carlo
C
Bonezzi
Cesare
C
Barbieri
Massimo
M
Bernardo
Antonio
A
Fratino
Pietro
P
D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000150:complications / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000150:complications / Q000473:pathology / Q000601:surgery*; D010146:Pain / Q000209:etiology / Q000601:surgery