Interventional Management Of Painful Metastatic Bone Tumors
Ahmed Mohamed Samy El Shimy;
Abstract
Metastatic cancer is the most common malignant disease of the bone. Skeletal metastases are the primary findings in breast, lung and prostate malignancies. The most common site of localization is the spinal column.
Patients with metastatic lesions are often in advanced stages of the disease at the time of diagnosis and they experience significant cancer-related pain. Treatment for painful osseous metastases may not only diminish pain, but may also improve quality of life and reduce skeletal morbidity.
Radiation therapy is a therapeutic strategy, but up to 20%–30% of patients do not respond to treatment. Surgical resection is almost never possible in patients with advanced disease and poor functional status. Systemic therapies may not be beneficial for reduced therapeutic response or toxicity.
Over the last ten years, interventional radiology takes a large place in the treatment of bone metastases using percutaneous image-guided interventional radiology procedures.
The aim of our study was to assess the role of interventional radiology by using radiofrequency ablation and embolization techniques in improving pain in patients with painful metastatic bone tumors.
Our study involved 20 patients presenting with painful metastatic bone tumors. They have been classified into two groups; group I involved 13 patients treated with RFA (65%), and group II involved 7 patients treated with embolization (35%).
In group I, most of the lesions were located in the ribs (n=5) (39 %) and the most common primary sites for these bone secondaries was HCC (n=7) (54%). The maximum pre-treatment lesion sizes varied from 2 cm to 5 cm with ablation sessions ranging from 1 to 3 ablation sessions.
The mean pre-treatment pain score in 13 patients was 9.2 with a maximum pain score of 10 in 6 patients (46%) and a minimum pain score of 8 in 3 patients (23%). At the end of 2 weeks, the mean post-treatment pain score was 0.6 with a maximum pain score of 2 in 1 patients (8%) and a minimum pain score of 0 in 6 patients (46%).
The mean pain score for 13 patients has bee
Patients with metastatic lesions are often in advanced stages of the disease at the time of diagnosis and they experience significant cancer-related pain. Treatment for painful osseous metastases may not only diminish pain, but may also improve quality of life and reduce skeletal morbidity.
Radiation therapy is a therapeutic strategy, but up to 20%–30% of patients do not respond to treatment. Surgical resection is almost never possible in patients with advanced disease and poor functional status. Systemic therapies may not be beneficial for reduced therapeutic response or toxicity.
Over the last ten years, interventional radiology takes a large place in the treatment of bone metastases using percutaneous image-guided interventional radiology procedures.
The aim of our study was to assess the role of interventional radiology by using radiofrequency ablation and embolization techniques in improving pain in patients with painful metastatic bone tumors.
Our study involved 20 patients presenting with painful metastatic bone tumors. They have been classified into two groups; group I involved 13 patients treated with RFA (65%), and group II involved 7 patients treated with embolization (35%).
In group I, most of the lesions were located in the ribs (n=5) (39 %) and the most common primary sites for these bone secondaries was HCC (n=7) (54%). The maximum pre-treatment lesion sizes varied from 2 cm to 5 cm with ablation sessions ranging from 1 to 3 ablation sessions.
The mean pre-treatment pain score in 13 patients was 9.2 with a maximum pain score of 10 in 6 patients (46%) and a minimum pain score of 8 in 3 patients (23%). At the end of 2 weeks, the mean post-treatment pain score was 0.6 with a maximum pain score of 2 in 1 patients (8%) and a minimum pain score of 0 in 6 patients (46%).
The mean pain score for 13 patients has bee
Other data
| Title | Interventional Management Of Painful Metastatic Bone Tumors | Other Titles | دور الأشعة التداخلية في علاج الأورام الثانوية المؤلمة في العظام | Authors | Ahmed Mohamed Samy El Shimy | Issue Date | 2015 |
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