title: Combined Microwave Ablation and Cementoplasty in Patients with Painful Bone Metastases at High Risk of Fracture.
abstract: OBJECTIVE
  To retrospectively evaluate the effectiveness of computed tomography-guided percutaneous microwave ablation (MWA) and cementoplasty in patients with painful bone metastases at high risk of fracture.
  
  
  METHODS
  Thirty-five patients with 37 metastatic bone lesions underwent computed tomography-guided MWA combined with cementoplasty (polymethylmethacrylate injection). Vertebrae, femur, and acetabulum were the intervention sites and the primary end point was pain relief. Pain severity was estimated by visual analog scale (VAS) before treatment; 1 week post-treatment; and 1, 6, and 12 months post-treatment. Functional outcome was assessed by improved patient walking ability. Radiological evaluation was performed at baseline and 3 and 12 months post-procedure.
  
  
  RESULTS
  In all patients, pain reduction occurred from the first week after treatment. The mean reduction in the VAS score was 84, 90, 90 % at week 1, month 1, and month 6, respectively. Improved walking ability occurred in 100 and 98 % of cases at the 1- and 6-month functional outcome evaluations, respectively. At the 1-year evaluation, 25 patients were alive, and 10 patients (28 %) had died because of widespread disease. The mean reduction in the VAS score and improvement in surviving patients' walking ability were 90 and 100 %, respectively. No patients showed evidence of local tumor recurrence or progression and pathological fracture in the treated sites.
  
  
  CONCLUSIONS
  Our results suggest that MWA combined with osteoplasty is safe and effective when treating painful bone metastases at high risk of fracture. The number of surviving patients at the 1-year evaluation confirms the need for an effective and long-lasting treatment.
authors.affiliation: Division of Interventional Radiology, Department of Oncological Radiology, Ocological Hospital "A. Businco", Regional Referral Center for Oncologic Diseases, 09100, Cagliari, Italy. clapusceddu@gmail.com.
authors.forename: Claudio
authors.initials: C
authors.lastname: Pusceddu
authors.affiliation: Department of Oncological Radiology, Oncological Hospital "A. Businco", Regional Referral Center for Oncological Diseases, 09100, Cagliari, Italy. barbara.sotgia@gmail.com.
authors.forename: Barbara
authors.initials: B
authors.lastname: Sotgia
authors.affiliation: Department of Oncological Radiology, Oncological Hospital "A. Businco", Regional Referral Center for Oncological Diseases, 09100, Cagliari, Italy. rosellafele@tiscali.it.
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Fele
authors.affiliation: Division of Interventional Radiology, Department of Oncological Radiology, Ocological Hospital "A. Businco", Regional Referral Center for Oncologic Diseases, 09100, Cagliari, Italy. nicolaballicu77@gmail.com.
authors.forename: Nicola
authors.initials: N
authors.lastname: Ballicu
authors.affiliation: Department of Oncological Radiology, Oncological Hospital "A. Businco", Regional Referral Center for Oncological Diseases, 09100, Cagliari, Italy. doclucamelis@tiscali.it.
authors.forename: Luca
authors.initials: L
authors.lastname: Melis
mesh_terms: D001843:Bone Cements / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000556:secondary* / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods*; D060826:Cementoplasty / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone; D006801:Humans; D008297:Male; D008872:Microwaves; D008875:Middle Aged; D019904:Polymethyl Methacrylate / Q000627:therapeutic use; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012306:Risk; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements; D019904:Polymethyl Methacrylate
keywords: Bone metastases; Interventional Radiology; Microwave ablation; Percutaneous therapies