Radiofrequency Ablation Safely Reduces Pain of Osseous Metastases
Last Updated: 2010-01-21 16:43:09 -0400 (Reuters Health)
By Michelle Rizzo
NEW YORK (Reuters Health) - Radiofrequency ablation (RFA) can safely reduce pain and elevate mood in patients who have metastatic cancer to bone, according to a report in the December 29th online issue of Cancer.
"Patients who don't respond to traditional means of pain palliation may benefit from radiofrequency ablation in order to improve their quality of life," lead researcher Dr. Damian E. Dupuy told Reuters Health.
While effective treatments are available, many studies have shown that cancer pain is undertreated. Dr. Dupuy from Brown University, Providence, Rhode Island, and colleagues examined the safety and effectiveness of CT-guided percutaneous RFA for painful osseous metastases.
Fifty-five patients with a single painful bone metastasis and a pain score of >50 on a 1 to 100 scale were included in the prospective study. Pain relief and mood change were assessed before and after RFA using 100-point scales.
The mean size of the treated tumor was 5.2 cm. Of the 55 patients, 13 (23.6%) did not have a 1-month follow-up measurement, and 23 (41.8%) did not have a 3-month follow-up measurement.
RFA significantly improved pain relief at 1 and 3 months. The average increase in pain relief from pre-RFA to 1 month was 26.3 points (p < 0.0001). The average increase from baseline to 3 months was 16.4 points (p = 0.02).
Compared to pre-RFA, the odds of lower pain severity were 14.0 times higher (p < 0.0001) at the 1 month follow-up and 8.0 times higher (p < 0.001) at the 3 month follow-up.
Patients also had significant increases in mood scores, which rose by 19.9 points (p < 0.0001) at 1 month and by 14.9 points (p = 0.005) at 3 months.
Overall, only three patients (5%) had grade 3 toxicities, including pain from RFA in one patient, neuropathic pain in one, and foot drop in one.
"Radiofrequency ablation is a less expensive alternative to radiotherapy, an outpatient band-aid procedure that is covered by insurance, and should be considered a treatment option for patients with unremitting cancer pain from a metastatic focus within the skeleton," Dr. Dupuy said.
Cancer 2010.
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