Effectiveness of combined treatment using CT-guided

ablation with radio-frequency and RT or microwave and RT

or cryotherapy and RT (RFA-RT/MW-RT/CRYO-RT) vs RT
only, in the management of bone metastasis
Poster No.:

C-1445

Congress:

ECR 2015

Type:

Scientific Exhibit

Authors:

A. Mancini, L. M. Gregori, F. Arrigoni, A. La Marra, S. Silvia

Mariani, L. Zugaro, A. Barile, C. Masciocchi; L'Aquila/IT

Keywords:

Interventional non-vascular, CT, Ablation procedures, Radiation

therapy / Oncology, Cancer, Metastases, Neoplasia

DOI:

10.1594/ecr2015/C-1445

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Aims and objectives

To evaluate the effectiveness of percutaneous Ct-guided ablation with RF or MW or
CRYO added to RT versus RT only in the relief of bone metastasiss pain.

Methods and materials

From May 2007, 49 oncologic patients were evaluated for a single painful bone
metastasis. All lesions were larger than 3 cm with a central poorly oxygenated and
necrotic area. Before ablation treatment for each patient we realized a validated visual
analogic scale (VAS) for pain assessment. Inclusion criteria was VAS from 4 to 10.
Exclusion criteria was the presence of other metastasis. Ablation had the role to destroy
the necrotic center, which is unlikely to be treated by RT. By CT-guiding the ablation
was done in 24 patients with radio-frequency (LeVeen need electrode Boston Scientific
Corporation), 7 patients with microwave (Single Evident Antenna, Covidien) and 18
patients with cryosystem (IceSeed, Galil Medical). All ablation were followed after 6 days
by single fraction RT at 800 cGyImages for this section:

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Fig. 1: Sternum metastasis from renal cancer

Fig. 2: Needle and Iceball

Fig. 3: Iliac metastasis from lung cancer + MicroWave needle

Page 3 of 11

Page 4 of 11

Page 5 of 11

Fig. 5: Rib metastasis from renal cancer + RF needle

Fig. 4: Gas ain the soft tissue after MicroWave treatment

Page 6 of 11

Results
Patients had pain relief for a period from 3 to 15 months (mean 8.1 months for CRYO,
7.4 for 7.4 for RF and 7.0 for MW) versus 3 to 15 months ( mean 2.4-3 months) of (RT).
Technical success was 100%. No major complications occurred. The mean VAS after
allo ablations improved overall by 80% from 9,1 to 1,1 (mean 7,1).
Images for this section:

Fig. 6: Post CRYO

Page 7 of 11

Fig. 7: RT of sternum metastasis

Fig. 8: Post MW treatment

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Fig. 9: Post RF treatment

Page 9 of 11

Fig. 10: RT of rib metastasis

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Conclusion
These datas suggest that, in comparison with RT only, tha adding of RF of MW or CRYO
ablation can lead to a significant improvement interms of pain relief in patients with painful
bone metastasis.

Personal information
I Andrea Dr Mancini indicate Dr Francesco Arrigoni (Department of Radiology, San
Salvatore Hospital-Via Lorenzo Natali 67100 L'Aquila-Italy) as the presenter of my
Scientific Paper (Control number: 2771/Topic: Interventional Radiology) entitled
"Effectiveness of combined treatment using CT-guided ablation with radiofrequency and RT or microwave and RT or cryotherapy and RT (RFA-RT/MW-RT/
CRYO-RT) vs RT only, in the management of bone metastasis".
Cordial Regards.Andrea Dr Mancini.

References
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Salazar OM, Sandhu T, da Motta NW, et al.: Fractionated half-body

irradiation (HBI) for the rapid palliation of widespread, symptomatic,
metastatic bone disease: a randomized Phase III trial of the International
Atomic Energy Agency (IAEA). Int J Radiat Oncol Biol Phys 50 (3): 765-75,
2001. [PUBMED Abstract]
Wu JS, Monk G, Clark T, et al.: Palliative radiotherapy improves pain and
reduces functional interference in patients with painful bone metastases: a
quality assurance study. Clin Oncol (R Coll Radiol) 18 (7): 539-44, 2006.
[PUBMED Abstract]
Chow E, Harris K, Fan G, et al.: Palliative radiotherapy trials for bone
metastases: a systematic review. J Clin Oncol 25 (11): 1423-36, 2007.
[PUBMED Abstract]

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