Aims and objectives
To achieve local control over the tumor and to arrest pain in patients with metastatic bone disease using percutaneous CT guided cryoablation.
Methods and materials
The cryoablation was carried out in 17 patients,
47-82 yo,
who had from 1 to 3 bone metastasesof breast,
lung and ovarian cancer in ribs,
scapula,
sacrum and bones of extremities.
The dimensions of the foci varied from 1 to 12 cm (4.2 ± 0.9 cm).
Depending on patient somatic status and localization of the tumor general or local anesthesia was applied.
Instrument navigation was performed under CT with the principle of "free hand" (serial or fluoroscopic mode) or with robotic navigation system.
If necessary...
Results
•Duration of hospitalization: 1 day
•Decrease in the index of the pain syndrome according to the McGill scale from the first day after the procedure (11patients - partial pain relief,6 patients - complete pain relief)
•Complications:
–slight disruption of sensation and a decrease in muscle strength in the peripheral regions in patient with tumor involving the sacral plexus
•0,5-1-year monitoring:
–10 patients- no local progression
–7 patient - local progression -> second procedure
Case 1.
•♀,
63 y.o.
•Ovarian cancer T3N0M1 (oss)
While control biopsy...
Conclusion
Cryoablation allows to achieve local control over the metastatic tumor and to arrest pain inmajoritypatients with bone metastases.
Also,
the advantages of cryoablation include minimal trauma,
short terms of hospitalization,
rapid effect of pain relief,
low number of complications,
the possibility of repeating the procedure,
low cost.
Personal information
Dr Ilya Burovik,
Ph D.,
Interventional Radiologist,N.N.
Petrov National Medical Research Center of Oncology,Saint-Petersburg,
Russia
DrGeorge Prokhorov,
Professor,N.N.
Petrov National Medical Research Center of Oncology,Saint-Petersburg,
Russia
DrAndrey Mishchenko,
Professor,
Head of Radiology Department,
N.N.
Petrov National Medical Research Center of Oncology,Saint-Petersburg,
Russia
References
Thacker PG,
Callstrom MR,
Curry TB,
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Palliation of painful metastatic disease involving bone with imaging-guided treatment: comparison of patients’ immediate response to radiofrequency ablation and cryoablation.
AJR 2011; 197:510–515
Bang HJ,
Littrup PJ,
Currier BP,
et al.
Percutaneous cryoablation of metastatic lesions from nonsmall-cell lung carcinoma: initial survival,
local control,
and cost observations.
J Vasc Interv Radiol 2012; 23:761–769
Bang HJ,
Littrup PJ,
Goodrich DJ,
et al.
Percutaneous cryoablation of metastatic renal cell carcinoma for local tumor control: feasibility,
outcomes,
and estimated cost-effectiveness...