title: A feasibility study of percutaneous Radiofrequency Ablation followed by Radiotherapy in the management of painful osteolytic bone metastases.
abstract: OBJECTIVE
  To determine whether Radiofrequency Ablation (RFA) followed by Radiotherapy (RT) (RFA-RT) produces better palliation in terms of pain than RT alone in patients with osteolytic bone metastases.
  
  
  METHODS
  Patients with solitary bone metastases and a pain score of least 5 or more on the VAS scale were selected. Fifteen patients were treated with RFA-RT (20 Gy delivered in 5 fractions of 4 Gy over 1 week) and were compared with a matched group (30 subjects) treated by RT.
  
  
  RESULTS
  A complete response in terms of pain relief at 12 weeks was documented in 16.6% (5/30) and 53.3% (8/15) of the subjects treated by RT or RFA-RT, respectively (p = 0.027). The overall response rate at 12 weeks was 93.3% (14 patients) in the group treated by RFA-RT and 59.9% (18 patients) in the group treated by RT (p = 0.048). Although recurrent pain was documented more frequently after RT (26.6%) than after RFA-RT (6.7%) the difference did not reach statistical significance. The morbidity related to RT did not significantly differ when this treatment was associated with RFA.
  
  
  CONCLUSIONS
  Our results suggest that RFA-RT is safe and more effective than RT. The findings described here should serve as a framework around which to design future clinical trials.
authors.affiliation: Department of Experimental Medicine, Division of Radiation Oncology and Radiobiology, S. Salvatore Hospital, University of L'Aquila, Medical School, Via Vetoio Coppito 2, 67100 L'Aquila, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Di Staso
authors.forename: L
authors.initials: L
authors.lastname: Zugaro
authors.forename: G L
authors.initials: GL
authors.lastname: Gravina
authors.forename: P
authors.initials: P
authors.lastname: Bonfili
authors.forename: F
authors.initials: F
authors.lastname: Marampon
authors.forename: L
authors.initials: L
authors.lastname: Di Nicola
authors.forename: A
authors.initials: A
authors.lastname: Conchiglia
authors.forename: L
authors.initials: L
authors.lastname: Ventura
authors.forename: P
authors.initials: P
authors.lastname: Franzese
authors.forename: M
authors.initials: M
authors.lastname: Gallucci
authors.forename: C
authors.initials: C
authors.lastname: Masciocchi
authors.forename: V
authors.initials: V
authors.lastname: Tombolini
mesh_terms: D000368:Aged; D001859:Bone Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003131:Combined Modality Therapy; D016001:Confidence Intervals; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D010014:Osteolysis / Q000532:radiotherapy / Q000601:surgery; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement; D010148:Intractable Pain / Q000532:radiotherapy / Q000601:surgery; D010166:Palliative Care; D011379:Prognosis; D011878:Radiotherapy / Q000379:methods*; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016019:Survival Analysis