title: Combination radiofrequency ablation and percutaneous osteoplasty for palliative treatment of painful extraspinal bone metastasis: a single-center experience.
abstract: OBJECTIVE
  To evaluate combined radiofrequency (RF) ablation and percutaneous osteoplasty (POP) in patients with painful extraspinal bone metastases.
  
  
  METHODS
  In a retrospective study, 38 patients with 54 extraspinal bone metastases (ilium, n = 24; acetabulum, n = 21; femur, n = 7; ischium, n = 1; tibia, n = 1) were treated with RF ablation and POP. All patients had pain refractory to analgesic medication with intensity > 3 on a visual analog scale (VAS). Changes in quality of life were evaluated based on pain relief (VAS score), function on a Karnofsky performance scale, and analgesic dose before and immediately after the procedure and during follow-up. VAS score was the primary outcome, and the others were secondary outcomes.
  
  
  RESULTS
  Technical success was achieved in 37 patients (97.4%). Mean VAS score declined significantly from 7.1 ± 1.5 before treatment to 2.2 ± 2.0 at 24 hours after treatment (P < .05), 1.6 ± 1.8 at 3 months after treatment (P < .05), and 1.3 ± 1.8 at 6 months after treatment (P < .05). Pain relief immediately after the procedure was reported by 35 patients (92.1%); pain regressed completely in 7 (18.4%) patients. After 6 months, narcotic analgesia had been suspended in 32 of 33 patients (97.0%). Pain was controlled by nonsteroidal antiinflammatory drugs in 8 patients (24.2%), and no analgesia was necessary in 24 patients (72.7%). Mean Karnofsky performance scale score after treatment was higher than before treatment (P < .05). The major complication rate was 2.6% (1 of 38 patients), with one case of vasovagal shock. The minor complication rate was 23.7% (9 of 38 patients).
  
  
  CONCLUSIONS
  RF ablation with POP is effective for pain relief and functional recovery in patients with painful extraspinal bone metastases and can significantly improve quality of life.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600 Yi Shan Road, Shanghai 200233, China.
authors.forename: Qing-Hua
authors.initials: QH
authors.lastname: Tian
authors.affiliation: Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600 Yi Shan Road, Shanghai 200233, China.. Electronic address: 649514608@qq.com.
authors.forename: Chun-Gen
authors.initials: CG
authors.lastname: Wu
authors.affiliation: Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600 Yi Shan Road, Shanghai 200233, China.
authors.forename: Yi-Feng
authors.initials: YF
authors.lastname: Gu
authors.affiliation: Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600 Yi Shan Road, Shanghai 200233, China.
authors.forename: Cheng-Jian
authors.initials: CJ
authors.lastname: He
authors.affiliation: Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600 Yi Shan Road, Shanghai 200233, China.
authors.forename: Ming-Hua
authors.initials: MH
authors.lastname: Li
authors.affiliation: Department of Diagnostic and Interventional Radiology, The Chinese People's Liberation Army Affiliated The 85th Hospital, Shanghai 200233, China.
authors.forename: Yong-de
authors.initials: YD
authors.lastname: Cheng
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000150:complications / Q000556:secondary* / Q000628:therapy*; D017115:Catheter Ablation / Q000009:adverse effects; D060826:Cementoplasty / Q000009:adverse effects; D002681:China; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D059408:Pain Management / Q000009:adverse effects / Q000379:methods*; D010147:Pain Measurement; D010166:Palliative Care; D011788:Quality of Life; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000700:Analgesics