Percutaneous image-guided cryoablation of painful metastases involving bone: Multicenter trial

Matthew R Callstrom, Damian E. Dupuy, Stephen B. Solomon, Robert A. Beres, Peter J. Littrup, Kirkland W. Davis, Ricardo Paz-Fumagalli, Cheryl Hoffman, Thomas D. Atwell, J. William Charboneau, Grant D. Schmit, Matthew Philip Goetz, Joseph Rubin, Kathy J. Brown, Paul J. Novotny, Jeff A Sloan

Research output: Contribution to journalArticle

146 Scopus citations

Abstract

BACKGROUND: This study sought to describe the results of a single-arm multicenter clinical trial using image-guided percutaneous cryoablation for the palliation of painful metastatic tumors involving bone. METHODS: Over a 44-month period, 61 adult patients with 1 or 2 painful bone metastases with a score of 4 or more on a scale of 0 to 10 (≥4/10) worst pain in a 24-hour period who had failed or refused conventional treatment were treated with percutaneous image-guided cryoablation. Patient pain and quality of life was measured using the Brief Pain Inventory prior to treatment, 1 and 4 days after the procedure, weekly for 4 weeks, and every 2 weeks thereafter for a total of 6 months. Patient analgesic use was also recorded at these same follow-up intervals. Complications were monitored. Analysis of the primary endpoint was undertaken via paired comparison procedures. RESULTS: A total of 69 treated tumors ranged in size from 1 to 11 cm. Prior to cryoablation, the mean score for worst pain in a 24-hour period was 7.1/10 with a range of 4/10 to 10/10. At 1, 4, 8, and 24 weeks after treatment, the mean score for worst pain in a 24-hour period decreased to 5.1/10 (P <.0001), 4.0/10 (P <.0001), 3.6/10 (P <.0001), and 1.4/10 (P <.0001), respectively. One of 61 (2%) patients had a major complication with osteomyelitis at the site of ablation. CONCLUSIONS: Percutaneous cryoablation is a safe, effective, and durable method for palliation of pain due to metastatic disease involving bone. Cancer 2013. © 2012 American Cancer Society. Single-arm multicenter trial of the use of percutaneous cryoablation for palliation of focal painful metastatic tumors involving bone was conducted using the Brief Pain Inventory as a measure for treatment response. This image-guided treatment is a safe, effective, and durable method for palliation of pain due to metastatic disease involving bone.

Original languageEnglish (US)
Pages (from-to)1033-1041
Number of pages9
JournalCancer
Volume119
Issue number5
DOIs
StatePublished - Mar 1 2013

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Keywords

  • cryoablation
  • image-guided
  • metastases
  • palliation
  • skeletal

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Callstrom, M. R., Dupuy, D. E., Solomon, S. B., Beres, R. A., Littrup, P. J., Davis, K. W., Paz-Fumagalli, R., Hoffman, C., Atwell, T. D., Charboneau, J. W., Schmit, G. D., Goetz, M. P., Rubin, J., Brown, K. J., Novotny, P. J., & Sloan, J. A. (2013). Percutaneous image-guided cryoablation of painful metastases involving bone: Multicenter trial. Cancer, 119(5), 1033-1041. https://doi.org/10.1002/cncr.27793