Safety and efficacy of image guided thermal ablation of painful metastatic bone tumors

Abstract

Skeletal metastases are the most common malignant bone tumors and also the most common cause of severe pain among patients with cancer. Current treatment for patients with painful bone metastases are primarily palliative and include localized therapies (radiation and surgery), systemic therapies (chemotherapy, hormonal therapy, radiopharmaceuticals, and bisphosphonates) and analgesics (opioids and non-steroidal anti-inflammatory drugs). Irradiation therapy may be effective for relieving pain. However, about 20–30% of patients with painful metastatic bone tumors do not respond to external irradiation therapy. In addition, the recurrence rate of pain following external irradiation therapy is reportedly 27%, and additional irradiation is difficult due to dose limits for normal structures. Nonresponsive tumors may instead undergo percutaneous ablation using different techniques, all of which aim to achieve thermal necrosis. These include thermal ablation by radiofrequency ablation (RFA) or microwave ablation (MWA) which are highly effective, efficient, minimally invasive and safe treating modality.