Painful metastases involving bone

Feasibility of percutaneous CT- and US-guided radio-frequency ablation

Matthew R Callstrom, J. William Charboneau, Matthew Philip Goetz, Joseph Rubin, Gilbert Y. Wong, Jeff A Sloan, Paul J. Novotny, Bradley D. Lewis, Timothy J. Welch, Michael A. Farrell, Timothy Maus, Robert A. Lee, Carl C. Reading, Ivy A Petersen, Deitra D. Pickett

Research output: Contribution to journalArticle

225 Citations (Scopus)

Abstract

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 c hemotherapy 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.

Original languageEnglish (US)
Pages (from-to)87-97
Number of pages11
JournalRadiology
Volume224
Issue number1
StatePublished - 2002

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Radio
Neoplasm Metastasis
Bone and Bones
Pain
Analgesics
Matched-Pair Analysis
Therapeutics
Quality Improvement
General Anesthesia
Contrast Media
Electrodes
Radiotherapy
Tomography
Quality of Life
Safety
Equipment and Supplies

Keywords

  • Bone neoplasms, secondary
  • Bone neoplasms, therapeutic radiology
  • Computed tomography (CT), guidance
  • Radio-frequency (RF) ablation

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Painful metastases involving bone : Feasibility of percutaneous CT- and US-guided radio-frequency ablation. / Callstrom, Matthew R; Charboneau, J. William; Goetz, Matthew Philip; Rubin, Joseph; Wong, Gilbert Y.; Sloan, Jeff A; Novotny, Paul J.; Lewis, Bradley D.; Welch, Timothy J.; Farrell, Michael A.; Maus, Timothy; Lee, Robert A.; Reading, Carl C.; Petersen, Ivy A; Pickett, Deitra D.

In: Radiology, Vol. 224, No. 1, 2002, p. 87-97.

Research output: Contribution to journalArticle

Callstrom, MR, Charboneau, JW, Goetz, MP, Rubin, J, Wong, GY, Sloan, JA, Novotny, PJ, Lewis, BD, Welch, TJ, Farrell, MA, Maus, T, Lee, RA, Reading, CC, Petersen, IA & Pickett, DD 2002, 'Painful metastases involving bone: Feasibility of percutaneous CT- and US-guided radio-frequency ablation', Radiology, vol. 224, no. 1, pp. 87-97.
Callstrom, Matthew R ; Charboneau, J. William ; Goetz, Matthew Philip ; Rubin, Joseph ; Wong, Gilbert Y. ; Sloan, Jeff A ; Novotny, Paul J. ; Lewis, Bradley D. ; Welch, Timothy J. ; Farrell, Michael A. ; Maus, Timothy ; Lee, Robert A. ; Reading, Carl C. ; Petersen, Ivy A ; Pickett, Deitra D. / Painful metastases involving bone : Feasibility of percutaneous CT- and US-guided radio-frequency ablation. In: Radiology. 2002 ; Vol. 224, No. 1. pp. 87-97.
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abstract = "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 c hemotherapy 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.",
keywords = "Bone neoplasms, secondary, Bone neoplasms, therapeutic radiology, Computed tomography (CT), guidance, Radio-frequency (RF) ablation",
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T1 - Painful metastases involving bone

T2 - Feasibility of percutaneous CT- and US-guided radio-frequency ablation

AU - Callstrom, Matthew R

AU - Charboneau, J. William

AU - Goetz, Matthew Philip

AU - Rubin, Joseph

AU - Wong, Gilbert Y.

AU - Sloan, Jeff A

AU - Novotny, Paul J.

AU - Lewis, Bradley D.

AU - Welch, Timothy J.

AU - Farrell, Michael A.

AU - Maus, Timothy

AU - Lee, Robert A.

AU - Reading, Carl C.

AU - Petersen, Ivy A

AU - Pickett, Deitra D.

PY - 2002

Y1 - 2002

N2 - 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 c hemotherapy 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.

AB - 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 c hemotherapy 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.

KW - Bone neoplasms, secondary

KW - Bone neoplasms, therapeutic radiology

KW - Computed tomography (CT), guidance

KW - Radio-frequency (RF) ablation

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VL - 224

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EP - 97

JO - Radiology

JF - Radiology

SN - 0033-8419

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