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Vascular and Interventional Radiology |
1 From the Departs of Radiology (M.R.C., J.W.C., B.D.L., T.J.W., M.A.F., T.P.M., R.A.L., C.C.R., D.D.P.), Oncology (M.P.G., J.R.), Anesthesiology (G.Y.W.), Biostatistics (J.A.S., P.J.N.), and Radiation Oncology (I.A.P.), Mayo Clinic, 200 First St SW, E2, Rochester, MN 55905. Received October 1, 2001; revision requested Dec 11; revision received Jan 15, 2002; accepted Feb 28. Supported in part by RITA Medical Systems, Mountain View, Calif. Address correspondence to J.W.C. (e-mail: charboneau.william@mayo.edu).
PURPOSE: To determine the safety and efficacy of radio-frequency (RF) ablation for pain reduction, quality of life improvement, and analgesics use reduction in patients with skeletal metastases.
MATERIALS AND METHODS: Over 10 months, 12 adult patients with a single painful osteolytic metastasis in whom radiation therapy or chemotherapy had failed and who reported severe pain (pain score 
4 [scale of 0–10]) over a 24-hour period were treated with percutaneous imaging-guided RF ablation with a multitined electrode while under general anesthesia. Patient pain was measured with a Brief Pain Inventory 1 day after the procedure, every week for 1 month, and thereafter every other week (total follow-up, 6 months). Patient analgesics use was also recorded at these follow-up intervals. Follow-up contrast material–enhanced computed tomography was performed 1 week after the procedure. Complications were monitored. Analysis of the primary end point was undertaken with paired comparison procedures.
RESULTS: Lesion size was 1–11 cm. Before RF ablation, mean worst pain score in a 24-hour period in 12 patients was 8.0 (range, 6–10). At 4 weeks after treatment, mean worst pain decreased to 3.1 (P = .001). Mean pain before treatment was 6.5 and decreased to 1.8 (P < .001) 4 weeks after treatment. Mean pain interference in general activity decreased from 6.6 to 2.7 (P = .002) 4 weeks after treatment. Eight of 10 patients using analgesics reported reduced use at some time after RF ablation. No serious complications were observed.
CONCLUSION: RF ablation of painful osteolytic metastases is safe, and the relief of pain is substantial.
© RSNA, 2002
Index terms: Bone neoplasms, secondary, 48.33 • Bone neoplasms, therapeutic radiology, 48.1269 • Computed tomography (CT), guidance, 48.12111, 48.12112 • Radiofrequency (RF) ablation, 48.1269
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