Purpose
The bony skeleton is the most common metastatic site from cancer after lungs.
Of patients who develop skeletal metastases,
approximately 50% of patients will develop poorly controlled pain during the course of their disease.
Because many patients fail to derive adequate pain relief using current conventional therapies,
multiple minimally invasive focal therapies have been explored as new strategies for the palliation of painful metastatic disease
The aim of our study is to evaluate safety and efficacy of percutaneous CT-guided cryoablation using multiple cryoprobes in the...
Methods and materials
From July 2010 to September 2014,
we treated 18 patients with percutaneous CT-guided cryoablation.
17 patients had osteolytic bone metastases; one patient had a recurrence of aggressive fibromatosis of the shoulder.
From the clinical point of view,
before treatment,
patients were evaluated by VAS scale for pain with a mean value of 7.6.
We placed,
with Fluoro-CT guide,
from three to six cryoprobes for each lesion; we placed all the probes before to start the treatment to perform a faster procedure.
The area of cryoablation...
Results
Follow-up at 3 and 6 months performed with CT,
showed no significant increase in volume of the treated lesions.
We recorded a reduction in pain in all patient (mean VAS dropped from 7.6 to 1.9) one week after treatment; this value remained substantially unchanged until the end of follow-up (6 months).
Conclusion
Our results show the effectiveness of cryoablation in terms of tumor mass control and pain relief.
The main advantages are the possibility to treat all the lesion at the same time with the use of multiple cryoprobes and the possibility to check in real time the volume treated; instead the main limit is represented by the low number of patients recruited and in the short time of follow-up,
even if all but one patients,
were cancer patients and so a long term follow-up was not...
References
• Callstrom,
M.R.,Dupuy,
D.
E.,
Solomon,
S.
B.,Beres,R.
A.,Littrup,
P.J.,
Davis,
K.W.,
et al.
(2012).Percutaneous image-guidedcryoablation ofpainfulmetastasesinvolving bone.Cancer,119(5),
1033–1041.
• Dupuy,
D.
E.,
Liu,
D.,
Hartfeil,
D.,
Hanna,
L.,
Blume,
J.
D.,
Ahrar,
K.,
et al.
(2010).
Percutaneous radiofrequency ablation of painful osseous metastases.
Cancer,
116(4),
989–997.
doi:10.1002/cncr.24837