Percutaneous thermal ablation of sacral metastases: Assessment of pain relief and local tumor control - 26/05/21
, Pierre De Marini a, Ian Leonard-Lorant a, Danoob Dalili b, c, Guillaume Koch a, Pierre A. Autrusseau a, Theo Mayer a, Julia Weiss a, Pierre Auloge a, Julien Garnon a, Afshin Gangi a, c
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Highlights |
• | Percutaneous thermal ablation of metastatic tumors of the sacrum is safe. |
• | Percutaneous thermal blation of painful sacral metastases results in significant long-lasting pain relief. |
• | Curative percutaneous thermal ablation of sacral metastases may result in suboptimal local tumor control. |
Abstract |
Purpose |
To retrospectively report on safety, pain relief and local tumor control achieved with percutaneous ablation of sacral bone metastases.
Materials and methods |
From February 2009 to June 2020, 23 consecutive patients (12 women and 11 men; mean age, 60±8 [SD] years; median, 60; range: 48-80 years) with 23 sacral metastases underwent radiofrequency (RFA) or cryo-ablation (CA), with palliative or curative intent at our institution. Patients’ demographics and data pertaining to treated metastases, procedure-related variables, safety, and clinical evolution following ablation were collected and analyzed. Pain was assessed with numerical pain rating scale (NPRS).
Results |
Sixteen (70%) patients were treated with palliative and 7 (30%) with curative intent. Mean tumor diameter was 38±19 (SD) mm (median, 36; range: 11-76). External radiation therapy had been performed on five metastases (5/23; 22%) prior to ablation. RFA was used in 9 (39%) metastases and CA in the remaining 14 (61%). Thermo-protective measures and adjuvant bone consolidation were used whilst treating 20 (87%) and 8 (35%) metastases, respectively. Five (22%) minor complications were recorded. At mean 31±21 (SD) (median, 32; range: 2-70) months follow-up mean NPRS was 2±2 (SD) (median, 1; range: 0–6) vs. 5±1 (median, 5; range: 4–8; P<0.001) at the baseline. Three metastases out of 7 (43%) undergoing curative ablation showed local progression at mean 4±4 (SD) (median, 2; range: 1-8) months follow-up.
Conclusion |
Percutaneous ablation of sacral metastases is safe and results in significant long-lasting pain relief. Local tumor control seems sub-optimal; however, further investigations are needed to confirm these findings due to paucity of data.
Le texte complet de cet article est disponible en PDF.Keywords : Bone neoplasms, Neoplasm metastasis, Pain management, Radiofrequency ablation, Sacrum
Abbreviations : CA, CTCAE, ECOG-PS, ERT, IQR, MWA, NPRS, RFA, SD
Plan
Vol 102 - N° 6
P. 355-361 - juin 2021 Retour au numéro
Article précédent
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