Analgesic Effects of Microwave Ablation of Bone and Soft Tissue Tumors Under Local Anesthesia

Abstract

MWA is feasible, safe, and effective in the management of painful refractory bone and soft tissue tumors. It may therefore be considered as a potential alternative to existing percutaneous ablation techniques in the management of bone and soft tissue tumors.

Evaluation of CT Image Guided Radiofrequency Ablation in the Management of Painful Bone Metastases Originating from NSCLC

“…A large randomized, controlled, multicenter phase III trial has shown Focused Ultrasound (FUS) to be effective in the treatment of painful bone metastases [17], confirming results of earlier retrospective reports [18]. Small case series also support benefit from other percutaneous methods of image-guided ablation, including microwave ablation, laser ablation, and irreversible electroporation to treat skeletal metastases, although the data are more limited [19][20][21][22][23][24][25][26]. These studies demonstrate that multiple ablation therapies are effective at palliation of pain due to metastatic skeletal disease.…”

Thermal Ablation of Bone Metastases

“…A single, prospective, pilot study and smaller retrospective case series have shown MWA to produce safe pain palliation and effective tumor necrosis. 24,[44][45][46][47][48] Evidence for LA is limited to a few reported cases. 26,49 Local Control of Oligometastatic Disease…”

Metastatic Osseous Pain Control: Bone Ablation and Cementoplasty

“…Similar reports can be found on MR-guided HIFU in the middle of the first paragraph, section 2 in Palliative therapy for pain reduction. 26,27,32,35,39,[50][51][52][53][54][55][56][57][58] The pathophysiology of pain reduction post-percutaneous ablation includes necrotizing tumor-periosteum interface, decompression of tumor volume, inhibition of osteoclast activity, and decrease in the nerve-stimulating cytokines released by the tumor. 5,7 According to the most recent NCCN guidelines concerning adult cancer pain (v2, 2016), percutaneous ablation may be considered for metastatic bone pain palliation in cases without an oncologic emergency (e.g., pathologic fracture or epidural disease), when pharmacologic therapy is inadequate and radiation therapy is contraindicated or not desired by the patient.…”