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Percutaneous image-guided cryoablation of painful metastases involving bone
Article first published online: 12 OCT 2012
Copyright © 2012 American Cancer Society
Volume 119, Issue 5, pages 1033–1041, 1 March 2013
How to Cite
Callstrom, M. R., Dupuy, D. E., Solomon, S. B., Beres, R. A., Littrup, P. J., Davis, K. W., Paz-Fumagalli, R., Hoffman, C., Atwell, T. D., Charboneau, J. W., Schmit, G. D., Goetz, M. P., Rubin, J., Brown, K. J., Novotny, P. J. and Sloan, J. A. (2013), Percutaneous image-guided cryoablation of painful metastases involving bone. Cancer, 119: 1033–1041. doi: 10.1002/cncr.27793
- Issue published online: 19 FEB 2013
- Article first published online: 12 OCT 2012
- Manuscript Accepted: 5 JUN 2012
- Manuscript Revised: 30 MAY 2012
- Manuscript Received: 30 APR 2012
This study sought to describe the results of a single-arm multicenter clinical trial using image-guided percutaneous cryoablation for the palliation of painful metastatic tumors involving bone.
Over a 44-month period, 61 adult patients with 1 or 2 painful bone metastases with a score of 4 or more on a scale of 0 to 10 (≥4/10) worst pain in a 24-hour period who had failed or refused conventional treatment were treated with percutaneous image-guided cryoablation. Patient pain and quality of life was measured using the Brief Pain Inventory prior to treatment, 1 and 4 days after the procedure, weekly for 4 weeks, and every 2 weeks thereafter for a total of 6 months. Patient analgesic use was also recorded at these same follow-up intervals. Complications were monitored. Analysis of the primary endpoint was undertaken via paired comparison procedures.
A total of 69 treated tumors ranged in size from 1 to 11 cm. Prior to cryoablation, the mean score for worst pain in a 24-hour period was 7.1/10 with a range of 4/10 to 10/10. At 1, 4, 8, and 24 weeks after treatment, the mean score for worst pain in a 24-hour period decreased to 5.1/10 (P < .0001), 4.0/10 (P < .0001), 3.6/10 (P < .0001), and 1.4/10 (P < .0001), respectively. One of 61 (2%) patients had a major complication with osteomyelitis at the site of ablation.
Percutaneous cryoablation is a safe, effective, and durable method for palliation of pain due to metastatic disease involving bone. Cancer 2013. © 2012 American Cancer Society.