Skip to main content
Top
Published in: European Radiology 9/2011

01-09-2011 | Oncology

A feasibility study of percutaneous radiofrequency ablation followed by radiotherapy in the management of painful osteolytic bone metastases

Authors: M. Di Staso, L. Zugaro, G. L. Gravina, P. Bonfili, F. Marampon, L. Di Nicola, A. Conchiglia, L. Ventura, P. Franzese, M. Gallucci, C. Masciocchi, V. Tombolini

Published in: European Radiology | Issue 9/2011

Login to get access

Abstract

Objectives

To determine whether Radiofrequency Ablation (RFA) followed by Radiotherapy (RT) (RFA-RT) produces better palliation in terms of pain than RT alone in patients with osteolytic bone metastases.

Methods

Patients with solitary bone metastases and a pain score of least 5 or more on the VAS scale were selected. Fifteen patients were treated with RFA-RT (20 Gy delivered in 5 fractions of 4 Gy over 1 week) and were compared with a matched group (30 subjects) treated by RT.

Results

A complete response in terms of pain relief at 12 weeks was documented in 16.6% (5/30) and 53.3% (8/15) of the subjects treated by RT or RFA-RT, respectively (p = 0.027). The overall response rate at 12 weeks was 93.3% (14 patients) in the group treated by RFA-RT and 59.9% (18 patients) in the group treated by RT (p = 0.048). Although recurrent pain was documented more frequently after RT (26.6%) than after RFA-RT (6.7%) the difference did not reach statistical significance. The morbidity related to RT did not significantly differ when this treatment was associated with RFA.

Conclusions

Our results suggest that RFA-RT is safe and more effective than RT. The findings described here should serve as a framework around which to design future clinical trials.
Literature
1.
go back to reference Chow E, Harris K, Fan G et al (2007) Palliative radiotherapy trials for bone metastases: a systematic review. J Clin Oncol 25:1423–1436PubMedCrossRef Chow E, Harris K, Fan G et al (2007) Palliative radiotherapy trials for bone metastases: a systematic review. J Clin Oncol 25:1423–1436PubMedCrossRef
2.
go back to reference Janjan N, Lutz ST, Bedwinek JM et al (2009) Therapeutic guidelines for the treatment of bone metastasis: a report from the American College of Radiology Appropriateness Criteria Expert Panel on Radiation Oncology. J Palliat Med 12:417–426PubMedCrossRef Janjan N, Lutz ST, Bedwinek JM et al (2009) Therapeutic guidelines for the treatment of bone metastasis: a report from the American College of Radiology Appropriateness Criteria Expert Panel on Radiation Oncology. J Palliat Med 12:417–426PubMedCrossRef
3.
go back to reference Lo SS, Sahagal A, Hartsell WF et al (2009) The treatment of bone metastasis with highly conformal radiation therapy: a brave new world or a costly mistake. Clin Oncol 21:662–664CrossRef Lo SS, Sahagal A, Hartsell WF et al (2009) The treatment of bone metastasis with highly conformal radiation therapy: a brave new world or a costly mistake. Clin Oncol 21:662–664CrossRef
4.
go back to reference Callstrom MR, Charboneau JW, Goetz MP et al (2002) Painful metastases involving bone: feasibility of percutaneous CT and US guided radiofrequency ablation. Radiology 224:87–97PubMedCrossRef Callstrom MR, Charboneau JW, Goetz MP et al (2002) Painful metastases involving bone: feasibility of percutaneous CT and US guided radiofrequency ablation. Radiology 224:87–97PubMedCrossRef
5.
go back to reference Goetz MP, Callstrom MR, Charboneau JW (2004) Percutaneous image-guided radiofrequency ablation of painful metastasis involving bone: a multicenter study. J Clin Oncol 22:300–306PubMedCrossRef Goetz MP, Callstrom MR, Charboneau JW (2004) Percutaneous image-guided radiofrequency ablation of painful metastasis involving bone: a multicenter study. J Clin Oncol 22:300–306PubMedCrossRef
6.
go back to reference Dupuy DE, Liu D, Hartfeil D et al (2010) Percutaneous radiofrequency ablation of painful osseous metastases: a multicenter American College of Radiology Imaging Network trial. Cancer 116:989–997PubMedCrossRef Dupuy DE, Liu D, Hartfeil D et al (2010) Percutaneous radiofrequency ablation of painful osseous metastases: a multicenter American College of Radiology Imaging Network trial. Cancer 116:989–997PubMedCrossRef
7.
go back to reference Widmann G, Bodner G, Bale R (2009) Tumour ablation: technical aspects. Cancer Imaging 9:63–67CrossRef Widmann G, Bodner G, Bale R (2009) Tumour ablation: technical aspects. Cancer Imaging 9:63–67CrossRef
8.
go back to reference Di Staso M, Zugaro L, Gravina GL, Bonfili P, Marampon F, Di Nicola L, Conchiglia A, Franzese P, Gallucci M, Masciocchi C, Tombolini V (2011) Can Radiotherapy be Combined with Radiofrequency Ablation in the Management of Symptomatic Osteolytic Skeletal Metastasis? Clin Oncol 23:65–66CrossRef Di Staso M, Zugaro L, Gravina GL, Bonfili P, Marampon F, Di Nicola L, Conchiglia A, Franzese P, Gallucci M, Masciocchi C, Tombolini V (2011) Can Radiotherapy be Combined with Radiofrequency Ablation in the Management of Symptomatic Osteolytic Skeletal Metastasis? Clin Oncol 23:65–66CrossRef
9.
go back to reference Harris W, Li K, Flynn C et al (2007) Worst, average or current pain in the Brief Pain Inventory: which should be used to calculate the response to palliative radiotherapy in patients with bone metastases. Clin Oncol 19:523–527CrossRef Harris W, Li K, Flynn C et al (2007) Worst, average or current pain in the Brief Pain Inventory: which should be used to calculate the response to palliative radiotherapy in patients with bone metastases. Clin Oncol 19:523–527CrossRef
10.
go back to reference Chow E, Wu JS, Hoskin P et al (2002) International consensus on palliative radiotherapy endpoints for future clinical trials in bone metastases. Radiother Oncol 64:275–280PubMedCrossRef Chow E, Wu JS, Hoskin P et al (2002) International consensus on palliative radiotherapy endpoints for future clinical trials in bone metastases. Radiother Oncol 64:275–280PubMedCrossRef
11.
go back to reference Goldberg SN, Grassi CJ, Cardella JF et al (2005) Society of interventional radiology technology assessment committee; international working group on image-guided tumor ablation. Imaged-guided tumor ablation: standardization of terminology and reporting criteria. Radiology 235:728–739PubMedCrossRef Goldberg SN, Grassi CJ, Cardella JF et al (2005) Society of interventional radiology technology assessment committee; international working group on image-guided tumor ablation. Imaged-guided tumor ablation: standardization of terminology and reporting criteria. Radiology 235:728–739PubMedCrossRef
12.
go back to reference Lutz S, Hoskin P, Chow E (2009) Update on palliative radiotherapy endpoints for bone metastases trials. Clin Oncol 21:659–661CrossRef Lutz S, Hoskin P, Chow E (2009) Update on palliative radiotherapy endpoints for bone metastases trials. Clin Oncol 21:659–661CrossRef
Metadata
Title
A feasibility study of percutaneous radiofrequency ablation followed by radiotherapy in the management of painful osteolytic bone metastases
Authors
M. Di Staso
L. Zugaro
G. L. Gravina
P. Bonfili
F. Marampon
L. Di Nicola
A. Conchiglia
L. Ventura
P. Franzese
M. Gallucci
C. Masciocchi
V. Tombolini
Publication date
01-09-2011
Publisher
Springer-Verlag
Published in
European Radiology / Issue 9/2011
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-011-2133-3

Other articles of this Issue 9/2011

European Radiology 9/2011 Go to the issue