PURPOSE The purpose of this study was to evaluate the feasibility, the safety and the efficacy of combined radiofrequency ablation and percutaneous cementoplasty for pain management and consolidation of painful bone metastasis. RATIONAL RF ablation has proved to be an excellent technique for pain management of bone metastasis without risk of compression fracture (no need of consolidation). Cementoplasty is an excellent technique for management of pain and consolidation in tumors involving weight-bearing bones (spine, acetabulum, condyles, talus, calcaneum), but without extension to surrounding tissues. The...

PATIENTS SELECTION From 02/1999 to 04/2005, 90 patients suffering from painful bone metastases or myeloma underwent percutaneous radiofrequency ablation combined to cementoplasty during the same session. 54 were males and 36 females, with mean age of 68.5 years. Primary tumors were lung (38), breast (21), myeloma (14), kidney (8), melanoma (7) and thyroid (2). Lesions were mainly located in the spine (61/90), but also in the iliac bone, acetabulum and ischium. Their mean diameter was 4.3 cm. All patients presented intense pain refractory to morphine...

RESULTS All procedures were technically successful. All patients could stand up within 48 hours. 93% of them reported a notable reduction of pain. The mean VAS decreased from 8.2 to 3.1. This improvement lasted for 1 to 24 months. 25 patients died within 2 months after the procedure due to advanced disease but without recurrence of pain at the treated area. No adverse event secondary to RF ablation occurred, particularly no neurological damage. Four minor cement leakages occurred (1 in the hip and 3 in...

CONCLUSION The occurrence of bone metastasis often changes the patient’s status. The treatment initially curative becomes palliative with two main goals to assure an acceptable quality of life: pain management and prevention or treatment of pathological fractures. For unresectable tumors, external beam radiation therapy is still considered as the gold standard and all our patients were previously treated by this method. Nevertheless, its global efficiency ranges from 60 to 90%, but with several potentially invaliding side-effects such as pathological radiation myelopathy, radic dermitis, pulmonary fibrosis,...

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Xavier BUY (MD) E mail : [email protected] Afshin GANGI (MD-PhD) E mail : [email protected] Department of Radiology B University Hospital of Strasbourg 1 place de l'Hôpital 67000 Strasbourg - FRANCE Tel : +33 3 88 11 62 80 Fax : +33 3 88 11 62 81