Sri Hari Sundararajan MD, Presenter: Nothing to Disclose

Marisa Giglio, Abstract Co-Author: Nothing to Disclose

Sudipta Roychowdhury MD, Abstract Co-Author: Consultant, Johnson & Johnson

Vyacheslav Gendel MD, Abstract Co-Author: Nothing to Disclose

Gaurav Gupta MD, Abstract Co-Author: Nothing to Disclose

John L. Nosher MD, Abstract Co-Author: Nothing to Disclose

The purpose of the study is to review the treatment experiences of patients treated at our institution with combination angiographic embolization, cryoablation or thermal ablation, and stabilization plasty for their pelvic/sacral tumor burden. This study hopes to assess if such combinational interventional therapy has the potential to become a mainstay treatment option in managing pelvic and sacral neoplasms.

A combined interventional paradigm was employed in 8 patients thus far over the last year: Phase I: Angiographic embolization of neoplasm Phase II: Cryoablation of solid tumor, followed by supportive sacroplasty Phase III: Image-guided drainage/TPA flush, followed by sclerosis of residual bed Procedures were performed under general anesthesia. Phase I was within 1 day to 1-2 weeks prior to Phase II and III dependent on lesion location and patient tolerance. Neurological monitoring were utilized in Phases 2 and 3 to assess integrity of sacral nerve function during procedures.   Each patient underwent pretreatment CT and/or MRI examination prior to therapy. All patients have undergone post-therapy follow-up imaging within 1-3 months. Medical records and imaging portfolios for these patients will be reviewed. A reassessment of pre and post procedure lesion measurements and quality of life outcomes will be performed. Linear regression will be performed to correlate results of imaging and quality of life assessment.

It is hypothesized that patients undergoing sequential combinational therapy will demonstrate significant decrease in lesion growth, as well as improved pain control and quality of life. It is unclear if survival will be affected by such measures, as patients with terminal disease pursued such procedures more so for symptomatic relief.  

An interventional paradigm consisting of combinational implementation of angiography-mediated embolization, thermal/radiofrequency ablation, and mechanical drainage followed by cavity sclerosis is expected to become a mainstay treatment option of pelvic and sacral neoplasms. The results of our review is expected to provide insight into its use in patients needing physical and symptomatic reduction of their pelvic/sacral tumor burden.

Sequential incorportation of several effective interventional treatments may play a role in the treatment paradigm of pelvic and sacral neoplasms. 

Sundararajan, S, Giglio, M, Roychowdhury, S, Gendel, V, Gupta, G, Nosher, J, Sequential Interventional Treatment of Pelvic/Sacral Tumors via Angiographic Embolization, Cryoablation, and Stabilization Plasty Combinational Therapy.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014469.html