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Percutaneous radiofrequency ablation of painful osseous metastases

A multicenter American College of Radiology Imaging Network trial

  1. Damian E. Dupuy MD1,†,*,
  2. Dawei Liu PhD2,3,
  3. Donna Hartfeil RN4,
  4. Lucy Hanna MS, MAT2,
  5. Jeffrey D. Blume PhD2,5,
  6. Kamran Ahrar MD6,
  7. Robert Lopez MD7,
  8. Howard Safran MD8,
  9. Thomas DiPetrillo MD9

Article first published online: 29 DEC 2009

DOI: 10.1002/cncr.24837

Issue

Cancer

Cancer

Volume 116, Issue 4, pages 989–997, 15 February 2010

Additional Information

How to Cite

Dupuy, D. E., Liu, D., Hartfeil, D., Hanna, L., Blume, J. D., Ahrar, K., Lopez, R., Safran, H. and DiPetrillo, T. (2010), Percutaneous radiofrequency ablation of painful osseous metastases. Cancer, 116: 989–997. doi: 10.1002/cncr.24837

Author Information

  1. 1

    Department of Diagnostic Imaging, the Warren Alpert Medical School at Brown University, Providence, Rhode Island

  2. 2

    Center for Statistical Sciences, Brown University, Providence, Rhode Island

  3. 3

    Department of Biostatistics, University of Iowa, Iowa City, Iowa

  4. 4

    American College of Radiology Imaging Network, Philadelphia, Pennsylvania

  5. 5

    Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee

  6. 6

    Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas

  7. 7

    Department of Radiology, University of Alabama at Birmingham Medical Center, Birmingham, Alabama

  8. 8

    Department of Hematology/Oncology, the Warren Alpert Medical School at Brown University, Providence, Rhode Island

  9. 9

    Department of Radiation Medicine, the Warren Alpert Medical School at Brown University, Providence, Rhode Island

  1. †

    Fax: (401) 444-5017

*Department of Diagnostic Imaging, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903

Publication History

  1. Issue published online: 2 FEB 2010
  2. Article first published online: 29 DEC 2009
  3. Manuscript Accepted: 15 JUN 2009
  4. Manuscript Revised: 4 JUN 2009
  5. Manuscript Received: 20 MAR 2009

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Keywords:

  • bone metastases;
  • radiofrequency ablation;
  • pain palliation;
  • tumor ablation

Percutaneous radiofrequency ablation was used to treat painful osseous metastases under computed tomography guidance. This cooperative group trial showed technical safety and statistically significant improvements in pain measures.

Abstract

BACKGROUND:

The study was conducted to determine whether radiofrequency ablation (RFA) can safely reduce pain from osseous metastatic disease.

METHODS:

The single-arm prospective trial included patients with a single painful bone metastasis with unremitting pain with a score >50 on a pain scale of 0-100. Percutaneous computed tomography-guided RFA of the bone metastasis to temperatures >60°C was performed. Endpoints were the toxicity and pain effects of RFA before and at 2 weeks, 1 month, and 3 months after RFA.

RESULTS:

Fifty-five patients completed RFA. Grade 3 toxicities occurred in 3 of 55 (5%) patients. RFA reduced pain at 1 and 3 months for all pain assessment measures. The average increase in pain relief from pre-RFA to 1-month follow-up is 26.3 (95% confidence interval [CI], 17.7-34.9; P < .0001), and the increase from pre-RFA to 3-month follow-up is 16.38 (95% CI, 3.4-29.4; P = .02). The average decrease in pain intensity from pre-RFA to 1-month follow-up was 26.9 (P < .0001) and 14.2 for 3-month follow-up (P = .02). The odds of lower pain severity at 1-month follow-up were 14.0 (95% CI, 2.3-25.7; P < .0001) times higher than at pre-RFA, and the odds at 3-month follow-up were 8.0 (95% CI, 0.9-15.2; P < .001) times higher than at pre-RFA. The average increase in mood from pre-RFA to 1-month follow-up was 19.9 (P < .0001) and 14.9 to 3-month follow-up (P = .005).

CONCLUSIONS:

This cooperative group trial strongly suggests that RFA can safely palliate pain from bone metastases. Cancer 2010. © 2010 American Cancer Society

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