Clinical benefits of femoroplasty: a nonsurgical alternative for the management of femoral metastases.
BACKGROUND
Bone metastases occur frequently in advanced cancer. The spine, pelvis, ribs, skull and femur are the most affected sites. It is reported that up to 83% of the patients develop pain at some point of the disease. The patient can also develop fractures and disability, particularly in the femur..


OBJECTIVE
To evaluate the effectiveness of percutaneous femoroplasty in patients with metastatic osseous disease located in the proximal femur (trochanter, neck, and femoral head).


METHODS
A retrospective clinical review, comparing pain status "before vs after" intervention.


METHODS
National Cancer Institute in Mexico.


METHODS
We included patients over 18 years old, with mild to severe pain due to metastasis in the proximal femur (trochanter, neck, or head), or with a high risk of fracture according to Mirels scale (> 8 points) or severe osteoporosis according to the World Health Organization (a Karnofsky score more than 50%). Exclusion criteria were femoral fracture. We recorded the following variables age, sex, type of neoplasm, concomitant therapy, We used the Karnofsky functionality scale, the VAS pain intensity assessment, the "Mayo Clinic" scale to measure improved functionality, and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative (EORTC QLQ-C15-PAL) (Spanish version) questionnaires. Follow-up was performed at 7 days, one month after femoroplasty, and during the individual outpatient that lasted one year on average.


RESULTS
Eighty subjects were enrolled. Seventy-three percent were women. The most frequent tumors were breast (46.3%), followed by multiple myeloma (18.7%). All patients had a decrease in the intensity of pain, analgesic consumption, and improved quality of life, at 7 and 30 days after the intervention. There were no complications with serious consequences. Two participants experienced polymethylmetacrylate (PMMA) leakage, without clinical or functional impact. In 4 patients, the needle was occluded during the filling process and we had to place another biopsy needle through the same entry site to finish the injection process.


CONCLUSIONS
The sample was a single group of patients evaluated before and after the femoroplasty. We did not include a control group.


CONCLUSIONS
The results of the current report suggest that femoroplasty, a percutaneous cement placement analogous to a vertebroplasty, might be a therapeutic option for patients with metastatic bone disease of the proximal femur, providing the patient an analgesic reduction and a better quality of life.
Instituto Nacional De Cancerologia, Mexico City, Mexico.
Ricardo
R
Plancarte
Jorge
J
Guajardo
Abelardo
A
Meneses-Garcia
Carolina
C
Hernandez-Porras
Faride
F
Chejne-Gomez
Roberto
R
Medina-Santillan
Georgina
G
Galindo-Hueso
Ulises
U
Nieves
Oscar
O
Cerezo
D001843:Bone Cements / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005266:Femoral Neoplasms / Q000523:psychology / Q000556:secondary* / Q000601:surgery*; D005269:Femur / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010148:Intractable Pain / Q000523:psychology / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D001843:Bone Cements