Cryoablation of bone, soft tissue, and nerve in the setting of uninterrupted systemic cancer therapies

Abstract

Purpose: To assess safety of cryoablation in cancer patients receiving uninterrupted systemic cancer therapies with regard to wound healing.

Materials and methods: In this single-institution IRB-approved retrospective study, all patients (29/50 (58 %) female, mean age 61.9 +/- 11.3 years) undergoing cryoablation of bone, soft tissue, or nerve for symptomatic treatment while on uninterrupted systemic therapy between 2019 and 2022 were included for analysis. Charts were reviewed to identify post-cryoablation infection or wound healing complication within 90 days after cryoablation. All patients received routine prophylactic intraprocedural antibiotics; no patients were prescribed antibiotics post-procedure.

Results: Sixty-nine cryoablations of bone (42/69, 61 %), soft tissue (17/69, 25 %) and nerve (10/69,14 %) were performed without interrupting ongoing traditional chemotherapy, targeted therapy, immunotherapy, investigational clinical trial therapy, or hormone therapy in 32/69 (35 %), 26/69 (38 %), 14/69 (20 %), 5/69 (7 %) respectively. There were 3/69 (4 %) patients with neutropenia (defined as absolute neutrophil count <1500 cells/mL). Agents known to delay wound healing (such as VEGF/R, E/FGFR inhibitors) or chronic steroids were not interrupted in 9/69 (13 %) and 36/69 (52 %) respectively. Prior to cryoablation, the treatment zone was previously embolized in 8/69 (12 %) and irradiated in 34/69 (49 %). By mean clinical follow up of 41 days (range, 1-98 days post-cryoablation), no procedure-site infections nor wound healing complications occurred.

Conclusion: Wound healing abnormalities were not observed when performing percutaneous cryoablation with uninterrupted systemic therapies in this study, even in treatment zones that had received radiotherapy and embolization.

Keywords: Chemotherapy; Cryoablation; Cryoneurolysis; NCCN; Pain; Radiotherapy.