Preoperative radiofrequency ablation in painful osteolytic long bone metastases

Alexander Di Francesco, Stefano Flamini, Luigi Zugaro, Carmine Zoccali

Research output: Contribution to journalArticle

Abstract

This study aimed to determine whether Radio-frequency Ablation (RFA) followed by prophylactic internal fixation produces better palliation in terms of pain and reduces the need for blood transfusion more than radiotherapy and surgical stabilization (RT-SS). Patients with solitary long bone metastases and a pain score of 5 or more on the VAS scale were selected. Fifteen patients were treated with RFA and surgical stabilization (RFA-SS) and were compared with a matched group (15 subjects) treated by radiotherapy and surgical stabilization (RT-SS). A complete response in terms of pain relief at 12 weeks was documented in 20% (3/15) and 53.3% (8/15) of the subjects treated by RT-SS or RFA-SS, respectively (p = 0.027). The overall response rate at 12 weeks was 93.3% (14 patients) in the group treated by RFA-SS and 59.9% (9 patients) in the group treated by RT-SS (p = 0.048). Although recurrent pain was documented more frequently after RT-SS (26.6%) than after RFASS (6.7%) the difference did not reach statistical significance. The morbidity related to RT-SS did not significantly differ when the treatment was associated with RFA. We observed a reduction in blood trans-fusion, as 3 patients in the RT-SS group required a blood transfusion, versus none in the RFA-SS group. Our results suggest that RFA-SS is safe and is more effective than RT-SS; furthermore, RFA may become an option for patients with metastases of the long bones to prevent tumour dissemination and reduce intraoperative blood loss. The findings described here should serve as a framework around which to design future clinical trials.

Original languageEnglish
Pages (from-to)523-530
Number of pages8
JournalActa Orthopaedica Belgica
Volume78
Issue number4
Publication statusPublished - 2012

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Keywords

  • Morbidity
  • Palliative care
  • Radiofrequency ablation
  • Skeletal metastases
  • Surgical stabilization

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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