Lorenzo Maria Gregori, Abstract Co-Author: Nothing to Disclose

Francesco Arrigoni, Presenter: Nothing to Disclose

Fernando Smaldone MD, Abstract Co-Author: Nothing to Disclose

Luigi Zugaro, Abstract Co-Author: Nothing to Disclose

Antonio Barile MD, Abstract Co-Author: Nothing to Disclose

Carlo Masciocchi MD, Abstract Co-Author: Nothing to Disclose

Aim of this study was to evaluate the role of percutaneous CT-guided cryoablation in the synergistic treatment with radiotherapy in the management of painful bone metastases.

From July 2011, one hundred and two oncologic patient, with histologically and radiologically confirmed painful bone metastases were included in the study. All subjects experienced pain localized to the site of the bone metastases with a score >5 on the validated visual analogue scale (VAS). Cryoablation was performed in 38 subjects. Eighteen of them underwent a radiation course (20 Gy in 5 daily fraction) 10 days after the ablation. These subjects were retrospectively matched with a group of subjects treated by CA or RT. Exclusion criteria were the presence of other visceral or not-visceral metastasized sites. The rate of pain relief in terms of complete (CR) and partial (PR) response and the changes in self-rated Quality of life (QoL) were measured 3 months after treatments.

A significant higher proportion of subjects treated by CA (37%) (p=0.016) or CA followed by RT (72%) (p< 0,01) experienced a CR compared to patients treated by RT alone (13%). Interestingly, the addition of RT to CA significantly improved the rate of CR compared to CA alone (p=0.034). The higher rate of CR observed in patients treated by CA or CA-followed RT paralleled with an improved self-rated QoL. Thirty-seven (84%) patients were successfully ablated without complications with the rate of major complications of 16%. Patients had pain relief for a period ranging from 3 to 24 months (mean 7.8 months). Technical success was 100%.

Combined treatment of CT-guided cryoablation and radiotherapy improves relief from pain due to bone metastases.

In the treatment on painful bone metastases, combined treatment of CT-guided cryoablation and radiotherapy offer the best therapeutic outcomes.

Gregori, L, Arrigoni, F, Smaldone, F, Zugaro, L, Barile, A, Masciocchi, C, A New Approach in the Treatment of Bone Metastases: Efficacy of CT-guided Cryotherapy Combined with Radiotherapy.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045643.html