Percutaneus osteoplasty in the treatment of extraspinal painful multiple myeloma lesions.
OBJECTIVE
The aim of our study was to assess the efficacy and safety of percutaneous osteoplasty (PO), a technical extension of percutaneous vertebroplasty, in the treatment of extraspinal bone lesions from multiple myeloma causing pain resistant to NSAID therapy or treated with opioids.


METHODS
Between March 2006 and January 2009, 39 patients (22 female), median age 64 years (range 48-88 years) with diagnosis of multiple myeloma, were treated with percutaneous osteoplasty for painful extraspinal bone lesions resistant to NSAID therapy or treated with opioids.


RESULTS
Technical success was achieved in all cases. Mean visual analog pain score (VAS) scores dropped from 8.4 ± 1 (range 6-10; pretreatment) to 2.1 ± 1.7 (range 0-7; 24-h posttreatment). Pain completely disappeared in six (15%) patients. Administration of analgesics was suspended in 16 (41%) patients whereas in 17 (43.5%) patients previously treated with opioids, residual pain was controlled by NSAIDs. In six (15%) patients, narcotics administration was continued due to the persistence of pain. All patients completed an at least 6-month follow-up with a median long-term VAS score of 2.4 ± 2.1 (range 0-9). In five (13%) patients, pain remission was complete, with no recurrence at 18 months from treatment.


CONCLUSIONS
Our study suggests that PO may be feasible, effective, and safe in the treatment of conventional therapy-resistant extraspinal painful multiple myeloma lesions providing long-lasting pain relief with occasional tumor control and a significant reduction in the assumption of analgesic drugs.
Masala
Salvatore
S
Department of Diagnostic and Molecular Imaging, Interventional Radiology, Nuclear Medicine and Radiation Therapy, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
Volpi
Tommaso
T
Fucci
Francesco P M
FP
Cantonetti
Maria
M
Postorino
Massimiliano
M
Simonetti
Giovanni
G
D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D019637:Orthopedic Procedures; D010146:Pain / Q000473:pathology / Q000601:surgery; D059408:Pain Management; D010147:Pain Measurement; D013997:Time Factors; D017211:Treatment Failure; D054854:Vertebroplasty / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*
D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal