title: Radiofrequency ablation alone or in combination with cementoplasty for local control and pain palliation of sacral metastases: preliminary results in 11 patients.
abstract: OBJECTIVE
  To determine the safety and effectiveness of radiofrequency ablation (RFA) to treat sacral metastases for pain palliation and local tumor control (LTC).
  
  
  METHODS
  An institutional tumor ablation registry was retrospectively reviewed for sacral RFA procedures performed between January 2012 and December 2015. Clinical history, pre-procedural imaging, and procedural details were reviewed to document indication for treatment, primary tumor histology, tumor volumes, presence of concurrent cementoplasty after RFA, and the occurrence of peri-procedural complications. Pain scores before and 4 weeks after the procedure were recorded. Post-procedure imaging was reviewed for imaging evidence of tumor progression. Long-term complications and duration of clinical follow-up were recorded.
  
  
  RESULTS
  During the study period, 11 RFA procedures were performed to treat 16 sacral metastases. All procedures were for pain palliation. Four procedures (36 %; 4 out of 11) were also performed with the intention of achieving LTC in patients with oligometastatic disease. Concurrent cementoplasty was performed in 63 % of cases (7 out of 11). The median pain score decreased from 8 (interquartile range, 6-9.25) at baseline to 3 (interquartile range, 1.75-6.3) 1 month following RFA (P = 0.004). In the 4 patients with oligometastatic disease, LTC was achieved in 3 patients (75 %; 3 out of 4) after a median follow-up of 7.6 months (range, 3.6-11.9 months). No acute or long-term complications were documented during the overall median clinical follow-up of 4.7 months (range, 0.9-28.7 months).
  
  
  CONCLUSIONS
  Radiofrequency ablation maybe a safe and potentially effective treatment for patients with painful sacral metastases and can achieve LTC in selected patients.
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, St Louis, MO, 63110, USA. madaelilt@mir.wustl.edu.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Madaelil
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, St Louis, MO, 63110, USA.
authors.forename: Adam N
authors.initials: AN
authors.lastname: Wallace
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, St Louis, MO, 63110, USA.
authors.forename: Jack W
authors.initials: JW
authors.lastname: Jennings
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000556:secondary*; D017115:Catheter Ablation; D060826:Cementoplasty; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain; D059408:Pain Management / Q000379:methods*; D012189:Retrospective Studies; D012447:Sacrum / Q000473:pathology; D016896:Treatment Outcome
keywords: Ablation; Metastases; Procedure; Sacrum; Technique