Cementoplasty in the management of painful extraspinal bone metastases: our experience.
OBJECTIVE
The aim of this study was to demonstrate the effectiveness of interventional techniques in the palliative management of painful extraspinal bone metastases.


METHODS
Cementoplasty alone or in combination with radiofrequency (RF) ablation was performed in 14 skeletal extravertebral segments in 13 patients with ages ranging from 50 to 74 (average 67) years. The primary tumours were myeloma (n=5), renal carcinoma (n=5), hepatocellular carcinoma (n=2) and bladder carcinoma (n=2). Metastases were located at the acetabulum (n=4), femur (n=5), humerus (n=1), scapula (n=2) and iliac bone (n=2). The clinical indication was a pain intensity score >4 on the visual analogue scale (VAS) partially or totally refractory to analgesic medication. Clinical evaluation was based on clinical and neurological conditions before and immediately after the procedure and during the follow-up.


RESULTS
Technical success was achieved in all cases. Ten patients were treated by cementoplasty alone and four cases by cementoplasty combined with RF ablation. After treatment, all patients experienced improved symptoms, as demonstrated by the VAS score, which remained constant during follow-up. All patients were followed for between 2 and 14 (average 6.1) months. We had one major complication in a patient who developed an abscess, which was treated by percutaneous drainage.


CONCLUSIONS
In our experience, cementoplasty alone for small lesions or combined with RF ablation in larger lesions is an effective and safe therapy in the palliative management of painful extraspinal bone metastases.
Basile
A
A
Department of Diagnostic and Interventional Radiology, Ospedale Ferrarotto, Via Citelli 16, 95124 Catania, Italy. antodoc@yahoo.com
Giuliano
G
G
Scuderi
V
V
Motta
S
S
Crisafi
R
R
Coppolino
F
F
Mundo
E
E
Banna
G
G
Di Raimondo
F
F
Patti
M T
MT
D000368:Aged; D001843:Bone Cements / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D006528:Carcinoma, Hepatocellular / Q000556:secondary; D002292:Carcinoma, Renal Cell / Q000556:secondary; D017115:Catheter Ablation; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology; D008113:Liver Neoplasms / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000556:secondary; D010147:Pain Measurement; D010166:Palliative Care; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D001843:Bone Cements
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