Skip to main content
Top
Published in: Supportive Care in Cancer 7/2011

01-07-2011 | Original Article

Percutaneus osteoplasty in the treatment of extraspinal painful multiple myeloma lesions

Authors: Salvatore Masala, Tommaso Volpi, Francesco P. M. Fucci, Maria Cantonetti, Massimiliano Postorino, Giovanni Simonetti

Published in: Supportive Care in Cancer | Issue 7/2011

Login to get access

Abstract

Purpose

The aim of our study was to assess the efficacy and safety of percutaneous osteoplasty (PO), a technical extension of percutaneous vertebroplasty, in the treatment of extraspinal bone lesions from multiple myeloma causing pain resistant to NSAID therapy or treated with opioids.

Methods

Between March 2006 and January 2009, 39 patients (22 female), median age 64 years (range 48–88 years) with diagnosis of multiple myeloma, were treated with percutaneous osteoplasty for painful extraspinal bone lesions resistant to NSAID therapy or treated with opioids.

Results

Technical success was achieved in all cases. Mean visual analog pain score (VAS) scores dropped from 8.4 ± 1 (range 6–10; pretreatment) to 2.1 ± 1.7 (range 0–7; 24-h posttreatment). Pain completely disappeared in six (15%) patients. Administration of analgesics was suspended in 16 (41%) patients whereas in 17 (43.5%) patients previously treated with opioids, residual pain was controlled by NSAIDs. In six (15%) patients, narcotics administration was continued due to the persistence of pain. All patients completed an at least 6-month follow-up with a median long-term VAS score of 2.4 ± 2.1 (range 0–9). In five (13%) patients, pain remission was complete, with no recurrence at 18 months from treatment.

Conclusion

Our study suggests that PO may be feasible, effective, and safe in the treatment of conventional therapy-resistant extraspinal painful multiple myeloma lesions providing long-lasting pain relief with occasional tumor control and a significant reduction in the assumption of analgesic drugs.
Literature
1.
go back to reference Mundy GR, Luben RA, Raisz LG, Oppenheim JJ, Buell DN (1974) Bone resorbing activity in supernatants from lymphoid cell lines. N Engl J Med 290:867–871PubMedCrossRef Mundy GR, Luben RA, Raisz LG, Oppenheim JJ, Buell DN (1974) Bone resorbing activity in supernatants from lymphoid cell lines. N Engl J Med 290:867–871PubMedCrossRef
2.
go back to reference Mundy GR, Martin TJ (1982) The hypercalcemia of malignancy: pathogenesis and management. Metabolism 31:1247–1277PubMedCrossRef Mundy GR, Martin TJ (1982) The hypercalcemia of malignancy: pathogenesis and management. Metabolism 31:1247–1277PubMedCrossRef
3.
go back to reference Valentin-Opran A, Charhon SA, Meunier PJ, Edouard CM, Arlot ME (1982) Quantitative histology of myeloma-induced bone changes. Br J Haematol 52:601–610PubMedCrossRef Valentin-Opran A, Charhon SA, Meunier PJ, Edouard CM, Arlot ME (1982) Quantitative histology of myeloma-induced bone changes. Br J Haematol 52:601–610PubMedCrossRef
4.
go back to reference Yeh HS, Berenson JR (2006) Treatment for myeloma bone disease. Clin Cancer Res 12(20):6279S–6284SPubMedCrossRef Yeh HS, Berenson JR (2006) Treatment for myeloma bone disease. Clin Cancer Res 12(20):6279S–6284SPubMedCrossRef
5.
go back to reference Masala S, Anselmetti GC, Marcia S, Massari F, Manca A, Simonetti G (2008) Percutaneous vertebroplasty in multiple myeloma vertebral involvement. J Spinal Disord Tech 21(5):344–348PubMedCrossRef Masala S, Anselmetti GC, Marcia S, Massari F, Manca A, Simonetti G (2008) Percutaneous vertebroplasty in multiple myeloma vertebral involvement. J Spinal Disord Tech 21(5):344–348PubMedCrossRef
6.
go back to reference Diamond TH, Hartwell T, Clarke W, Manoharan A (2004) Percutaneous vertebroplasty for acute vertebral body fracture and deformity in multiple myeloma: a short report. Br J Haematol 124:485–487PubMedCrossRef Diamond TH, Hartwell T, Clarke W, Manoharan A (2004) Percutaneous vertebroplasty for acute vertebral body fracture and deformity in multiple myeloma: a short report. Br J Haematol 124:485–487PubMedCrossRef
7.
go back to reference Jensen ME, Kallmes DE (2002) Percutaneous vertebroplasty in the treatment of malignant spine disease. Cancer J 8:194–206PubMedCrossRef Jensen ME, Kallmes DE (2002) Percutaneous vertebroplasty in the treatment of malignant spine disease. Cancer J 8:194–206PubMedCrossRef
8.
go back to reference Farrar JT, Berlin JA, Strom BL (2003) Clinically important changes in acute pain outcome measures: a validation study. J Pain Symptom Manage 25(5):406–411PubMedCrossRef Farrar JT, Berlin JA, Strom BL (2003) Clinically important changes in acute pain outcome measures: a validation study. J Pain Symptom Manage 25(5):406–411PubMedCrossRef
9.
go back to reference Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole RM (2001) Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain 94(2):149–158PubMedCrossRef Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole RM (2001) Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain 94(2):149–158PubMedCrossRef
10.
go back to reference Adamietz IA, Schöber C, Schulte RW, Peest D, Renner K (1991) Palliative radiotherapy in plasma cell myeloma. Radiother Oncol 20(2):111–116PubMedCrossRef Adamietz IA, Schöber C, Schulte RW, Peest D, Renner K (1991) Palliative radiotherapy in plasma cell myeloma. Radiother Oncol 20(2):111–116PubMedCrossRef
11.
go back to reference Mill WB, Griffith R (1980) The role of radiation therapy in the management of plasma cell tumors. Cancer 45:647–652PubMedCrossRef Mill WB, Griffith R (1980) The role of radiation therapy in the management of plasma cell tumors. Cancer 45:647–652PubMedCrossRef
12.
go back to reference Farhangi M, Ossermann EF (1973) The treatment of multiple myeloma. Semin Hematol 10:149–161PubMed Farhangi M, Ossermann EF (1973) The treatment of multiple myeloma. Semin Hematol 10:149–161PubMed
13.
go back to reference Anselmetti GC, Manca A, Ortega C, Grignani G, Debernardi F, Regge D (2008) Treatment of extraspinal painful bone metastases with percutaneous cementoplasty: a prospective study of 50 patients. Cardiovasc Interv Radiol 31(6):1165–1173CrossRef Anselmetti GC, Manca A, Ortega C, Grignani G, Debernardi F, Regge D (2008) Treatment of extraspinal painful bone metastases with percutaneous cementoplasty: a prospective study of 50 patients. Cardiovasc Interv Radiol 31(6):1165–1173CrossRef
14.
go back to reference Basile A, Giuliano G, Scuderi V, Motta S, Crisafi R, Coppolino F, Mundo E, Banna G, Di Raimondo F, Patti MT (2008) Cementoplasty in the management of painful extraspinal bone metastases: our experience. Radiol Med 113(7):1018–1028PubMedCrossRef Basile A, Giuliano G, Scuderi V, Motta S, Crisafi R, Coppolino F, Mundo E, Banna G, Di Raimondo F, Patti MT (2008) Cementoplasty in the management of painful extraspinal bone metastases: our experience. Radiol Med 113(7):1018–1028PubMedCrossRef
15.
go back to reference Zhou B, Wu CG, Li MH, Gu YF, Cheng YD (2009) Percutaneous osteoplasty for painful sternal lesion from multiple myeloma. Skeletal Radiol 38(3):281–285PubMedCrossRef Zhou B, Wu CG, Li MH, Gu YF, Cheng YD (2009) Percutaneous osteoplasty for painful sternal lesion from multiple myeloma. Skeletal Radiol 38(3):281–285PubMedCrossRef
16.
go back to reference Dean JR, Ison KT, Gishen P (2000) The strengthening effect of percutaneous vertebroplasty. Clin Radiol 55:471–476PubMedCrossRef Dean JR, Ison KT, Gishen P (2000) The strengthening effect of percutaneous vertebroplasty. Clin Radiol 55:471–476PubMedCrossRef
17.
go back to reference Deramond H, Wright NT, Belkoff SM (1999) Temperature elevation caused by bone cement polymerization during vertebroplasty. Bone 25(2):17S–21SPubMedCrossRef Deramond H, Wright NT, Belkoff SM (1999) Temperature elevation caused by bone cement polymerization during vertebroplasty. Bone 25(2):17S–21SPubMedCrossRef
18.
go back to reference Zoarski GH, Snow P, Olan WJ, Stallmeyer MJ, Dick BW, Hebel JR, De Deyne M (2002) Percutaneous vertebroplasty for osteoporotic compression fractures: quantitative prospective evaluation of long-term outcomes. J Vasc Interv Radiol 13:139–148PubMedCrossRef Zoarski GH, Snow P, Olan WJ, Stallmeyer MJ, Dick BW, Hebel JR, De Deyne M (2002) Percutaneous vertebroplasty for osteoporotic compression fractures: quantitative prospective evaluation of long-term outcomes. J Vasc Interv Radiol 13:139–148PubMedCrossRef
19.
go back to reference Mathis JM, Barr JD, Belkoff SM, Barr MS, Jensen ME, Deramond H (2001) Percutaneous vertebroplasty: a developing standard of care for vertebral compression fractures. AJNR Am J Neuroradiol 22:373–381PubMed Mathis JM, Barr JD, Belkoff SM, Barr MS, Jensen ME, Deramond H (2001) Percutaneous vertebroplasty: a developing standard of care for vertebral compression fractures. AJNR Am J Neuroradiol 22:373–381PubMed
20.
go back to reference Tran Thang NN, Abdo G, Martin JB, Seium-Neberay Y, Yilmaz H, Verbist MC, Rufenacht D, Sappino AP, Dietrich PY (2008) Percutaneous cementoplasty in multiple myeloma: a valuable adjunct for pain control and ambulation maintenance. Support Care Cancer 16(8):891–896PubMedCrossRef Tran Thang NN, Abdo G, Martin JB, Seium-Neberay Y, Yilmaz H, Verbist MC, Rufenacht D, Sappino AP, Dietrich PY (2008) Percutaneous cementoplasty in multiple myeloma: a valuable adjunct for pain control and ambulation maintenance. Support Care Cancer 16(8):891–896PubMedCrossRef
21.
go back to reference San Millan RD, Burkhardt K, Jean B, Muster M, Martin JB, Bouvier J, Fasel JH, Rufenacht DA, Kurt AM (1999) Pathology findings with acrylic implants. Bone 25:85S–90SCrossRef San Millan RD, Burkhardt K, Jean B, Muster M, Martin JB, Bouvier J, Fasel JH, Rufenacht DA, Kurt AM (1999) Pathology findings with acrylic implants. Bone 25:85S–90SCrossRef
Metadata
Title
Percutaneus osteoplasty in the treatment of extraspinal painful multiple myeloma lesions
Authors
Salvatore Masala
Tommaso Volpi
Francesco P. M. Fucci
Maria Cantonetti
Massimiliano Postorino
Giovanni Simonetti
Publication date
01-07-2011
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 7/2011
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-010-0910-1

Other articles of this Issue 7/2011

Supportive Care in Cancer 7/2011 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine