Ralf Thorsten Hoffmann MD, Presenter: Nothing to Disclose

Tobias Franz Jakobs MD, Abstract Co-Author: Nothing to Disclose

Christoph Gregor Trumm MD, Abstract Co-Author: Nothing to Disclose

Thomas K. Helmberger MD, Abstract Co-Author: Nothing to Disclose

Maximilian F. Reiser MD, Abstract Co-Author: Nothing to Disclose

This retrospective study aimed to evaluate the feasibility, safety, and effectiveness regarding pain reduction after combination of RFA and osteoplasty in the treatment of malignant, osteolytic bone neoplasms.

23 patients with 28 osteolytic bone metastases (spine (n = 16), iliac bone (n = 3), sacrum (n = 2), distal femur (n = 1)) were treated. Procedures were performed under conscious analgo sedation and CT fluoroscopic guidance. Two different RF systems were used (Rita Medical, Mountain View or Boston Scientific, Natick, US). The RF was followed by cement injection using vertebroplasty set (OptiMed CementoRe, Germany) with a pressure syringe and a low viscosity bone cement (Osteopal V, Biomet). Pain relief was evaluated using visual analogue scale score (VAS score) and the possibility of reducing analgesics. The effect of stabilization was assessed by MSCT imaging immediately after the procedure. A good distribution of the cement between both endplates of a vertebral body or a complete filling of the osteolyses in other bones was considered as success.

Technical success of combined treatment was 100 % independent from the area treated. No procedure has to be aborted due to missing cooperation of the patients. Significant pain relief was achieved in all patients indicated by a reduction of pain rating on the VAS from 8.8 to 3.8 (before and after the treatment). 18 of 23 patients were able to reduce the amount of analgesics or were able to take weaker medication. In all patients a sufficient result regarding the cement distribution was achieved with only small cement leakages into the surrounding tissue without clinical relevance. Other complications and treatment related deaths did not occur.

The combined therapy is both feasible and useful for the treatment of osteolytic bone metastases regarding pain relief and stabilization. However, a comparison with osteoplasty or RF ablation alone and the long-term effect is needed.

Combining RF ablation and osteoplasty reduces pain caused by osteolyses nearly immediately and increases quality of life in the highly pallitaive situation significant.

Hoffmann, R, Jakobs, T, Trumm, C, Helmberger, T, Reiser, M, Radiofrequency Ablation (RFA) in Combination with Osteoplasty for the Treatment of Bone Malignancies.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5006650.html