Thermal ablation to relieve pain from metastatic bone disease: a systematic review View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-01-09

AUTHORS

Nicolò Gennaro, Luca Maria Sconfienza, Federico Ambrogi, Sara Boveri, Ezio Lanza

ABSTRACT

OBJECTIVE: To review the efficacy of percutaneous thermal ablation (TA) of bone metastases (radiofrequency ablation [RFA], microwave ablation [MWA], cryoablation [CA], and MR-guided focused ultrasound [MRgFUS]) in reducing pain in patients with advanced stage cancer. MATERIALS AND METHODS: We searched MEDLINE/PubMed, MEDLINE In-Process, BIDS ISI, Embase, CINAHL, and the Cochrane database using the keywords "ablation," "painful," "bone," and "metastases" combined in multiple algorithms. Inclusion criteria were: original clinical studies published between 2001 and 2018; performance of RFA, MWA, CA or MRgFUS; and quantitative pain assessment before/after TA of bone metastasis. RESULTS: Eleven papers (3 on RFA, 1 on MWA, 2 on CA, and 5 on MRgFUS) involving 364 patients were reviewed. A technical success rate of 96-100% was reported, with follow-up for up to 6 months. At baseline, pain scores ranged from 5.4 to 8, at 1-4 weeks from 0.5 to 5, and at 12 weeks from 0.3 to 4.5. Mean pain reduction compared with baseline ranged from 26 to 91% at 4 weeks and from 16% to 95% at 12 weeks. MWA treatments caused no complications, whereas MRgFUS showed the highest complication rate. The number of minor complications observed ranged from 0 to 59 (complication ratio 0-1.17), whereas the number of significant adverse effects ranged from 0 to 4 (complication ratio 0-0.04). CONCLUSION: All techniques achieved pain relief after 1 and 3 months, in up to 91% and 95% of patients respectively. MWA showed a negligible complication rate, whereas MRgFUS is associated with a noteworthy rate of adverse events. Future studies should adopt a standardized pain reporting scale to allow for meta-analysis. More... »

PAGES

1-9

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00256-018-3140-0

DOI

http://dx.doi.org/10.1007/s00256-018-3140-0

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1111312225

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30627778


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