Percutaneous image-guided ablation of bone metastases: local tumor control in oligometastatic patients

Int J Hyperthermia. 2018;35(1):493-499. doi: 10.1080/02656736.2018.1508760. Epub 2018 Oct 11.

Abstract

Introduction: Percutaneous image-guided cryo- (CA) and radiofrequency- (RFA) ablations have been widely used in the treatment of painful bone metastases (BM). However, paucity of data is available for the performance of these treatments when used with a curative intent. The aim of this study is to investigate the local progression free-survival (LPFS) after radical percutaneous image-guided ablation of BM in oligometastatic patients, and to identify predictive factors associated with local tumor progression.

Materials and methods: This is a retrospective review of all patients who underwent percutaneous image-guided CA or RFA of BM with a radical intent between 2007 and 2018.

Results: Forty-six patients with a total of forty-nine BM underwent percutaneous image-guided CA (N = 37; 75,5%) or RFA (N = 12; 24,5%). Primary malignancies included thyroid (N = 11, 22.5%), breast (N = 21; 42.9%), lung (N = 8; 16.3%) and other (N = 9; 18,3%) cancers. Additional consolidation was performed after ablation in 20.4% cases (N = 10). Mean follow-up was 34.1 ± 22 months. Local progression at the treated site was observed in 28.5% cases (N = 14); 1- and 2-year LPFS was 76.8% and 71.7%, respectively. Size of BM (>2 cm) predicted local tumor progression (p = .002).

Conclusions: Percutaneous image-guided locoregional therapies used in the radical treatment of BM in oligometastatic patients demonstrate significant rates of LPFS providing the size of BM ≤2 cm.

Keywords: bone consolidation; radical treatment; bone metastases; cryoablation; radiofrequency ablation.

MeSH terms

  • Bone Neoplasms / diagnostic imaging*
  • Bone Neoplasms / pathology
  • Bone Neoplasms / secondary*
  • Catheter Ablation / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Retrospective Studies