Efficacy of single fraction conventional radiation therapy for painful uncomplicated bone metastases: a systematic review and meta-analysis

David, Elizabeth; Kaduri, S.; Yee, Albert; Chow, Edward; Sahgal, Arjun; Chan, Stephanie; Hanna, Ramez

doi:10.21037/apm.2016.12.02

Cited by 29 publications

(8 citation statements)

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“…The use of RFA to assist PVP is safe and reliable. Bone cement was injected into the cavity that formed after RFA, and the leakage of bone cement in the venous and posterior wall of the vertebral body was significantly reduced, which may be related to the formation of thrombus during the ablation process [ 20 ]. The mechanism by which RFA reduces pain in bone metastases is unclear.…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy and safety of bone cement combined with radiofrequency ablation in the treatment of spinal metastases

Geng

et al. 2020

BMC Neurol

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Background To investigate the clinical efficacy and safety of bone cement combined with radiofrequency ablation (RFA) in the treatment of spinal metastases. Methods The medical records of patients with spinal metastatic tumor admitted to our hospital from January 2016 to December 2018 were retrospectively analyzed. Based on different surgical methods, the patients were divided into groups A (treated with RFA combined with bone cement) and B (treated with bone cement only). Group A included 35 patients with 47 segments of diseased vertebral bodies. Group B consisted of 52 patients with 78 vertebral segments. Pain, quality of life score, vertebra height, bone cement leakage, postoperative tumor recurrence, and complications were assessed 3 days and 1 and 6 months after surgery. Results All the patients had smooth operation without paraplegia, spinal cord injury, and perioperative death. Visual analogue scales (VAS) and Oswestry Disability Index (ODI) scores of the two groups significantly improved 3 days and 1 month after surgery compared with those before surgery (P < 0.05), but no significant difference was observed between the two groups (P > 0.05). Six months after surgery, the VAS and ODI scores of patients in group A were lower than those in group B, with statistically significant differences (P < 0.05). The postoperative vertebral body height of the two groups significantly increased compared with that before surgery, and the difference was statistically significant (P < 0.05). Meanwhile, no significant difference was observed between the two groups (P > 0.05). Postoperative bone cement permeability in group A was 6.4%, and postoperative tumor recurrence rate was 11.4%. The permeability of bone cement in group B was 20.5%, and the tumor recurrence rate was 30.8%. The bone cement permeability and tumor recurrence rate in group A were lower than those in group B, with statistically significant differences (P < 0.05). Conclusions Bone cement combined with RFA for the treatment of spinal metastases can achieve good efficacy, desirable analgesic effect, low incidence of complications, small surgical trauma, and high safety. The proposed method has the value of clinical popularization and application.

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Section: Discussionmentioning

confidence: 99%

Clinical efficacy and safety of bone cement combined with radiofrequency ablation in the treatment of spinal metastases

Geng

et al. 2020

BMC Neurol

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“…We identified 2232 studies in the initial screening, and after evaluating abstracts and full texts, 20 publications were selected for full-text assessment. Eventually, 12 studies [12], [13], [14], [15], [16], [17], [18], [19], [20], [21], [22], [23] were included in this systematic review (Fig. 2).…”

Section: Resultsmentioning

confidence: 99%

Analgesia from percutaneous thermal ablation plus cementoplasty for cancer bone metastases

Sun

Zhang

et al. 2019

Journal of Bone Oncology

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BackgroundThe purpose of this study was to review recent research related to the analgesic effect of ablation therapy combined with cementoplasty, as well as to identify the duration of analgesic effect and risk for cement leaks.MethodsA systematic literature search using PubMed, Web of Science, and annual meeting proceedings of the oncology society and other organizations were conducted.ResultsTwelve retrospective studies met the inclusion criteria. Four of the studies included in the review assessed the changes immediately after treatment. Five studies were subjected to analyses of analgesic effect of combined percutaneous thermal ablation and Cementoplasty at 24 weeks after treatment. Incidences of leakage of bone cement during surgery were detected in 4 out of 12 studies. The change of mean pain scores at 1 days, at 1 week, and at 4 weeks, 12 weeks, and 24 weeks after treatment were −3.90 (95% CI: −4.80 to −3.00), −4.55 (95% CI:−5.46 to −3.64), −4.78 (95% CI: −5.70 to −3.86), −5.16 (95% CI: −6.39 to −3.92), and −5.91 (95% CI: −6.63 to −5.19). The relative risk of cement leakage was 0.10 (95% CI: −6.63 to −5.19).ConclusionsOur systematic review suggested that thermal ablation combined with cementoplasty could be a safe and effective intervention for the management of bone metastases-induced pain.

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“…Spinal metastasis affects 5−10% of patients with cancer, and about 90% of symptomatic patients suffer from severe pain due to biochemical stimulation, tumor mass effect and related pathologic fracture [26] , [35] , [36] , [37] , [38] , [39] , [40] , [41] . These patients are also at high risk of metastatic spinal cord compression caused by tumor extension and pathological fracture of vertebral bodies, resulting in decreased quality of life and shortened life expectancy [42] .…”

Section: Discussionmentioning

confidence: 99%

Thermal effect of percutaneous radiofrequency ablation with a clustered electrode for vertebral tumors: In vitro and vivo experiments and clinical application

Zhao

Peng

Chen

et al. 2018

Journal of Bone Oncology

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PurposeTo investigate effects and heat distribution of radiofrequency ablation (RFA) on vertebral tumors in vitro and in vivo swine experiments and its clinical application.Materials and methodsRFA was performed on the swine spine in vitro and in vivo for 20 min at 90 °C at the electrode tip, and the temperature at the electrode tip and surrounding tissues were recorded. Clinical application of ablation combined with vertebroplasty was subsequently performed in 4 patients with spinal tumors.ResultsIn the in vitro study, the mean temperature at the front and ventral wall of the spinal canal was 50.8 °C and 43.6 °C, respectively, at 20 mm significantly greater than 37.7 °C and 33.7 ± 1.7 °C, respectively, at 10 mm ablation depth. The coagulative necrosis area was significantly (P < 0.0001) greater at 20 mm depth than at 10 mm depth (mean 17.0 × 20.7 mm2 vs. 14.2 × 16.6 mm2). In the in vivo experiment, the local temperature increased significantly (P < 0.05) from around 36 °C before ablation to over 41 °C at 20 min after ablation, with the temperature at the electrode tip (90.4 °C) and within the vertebral body (67.0 °C) significantly (P < 0.05) greater than at the posterior (41.9 °C) and lateral wall (41.8 °C). From 2 to 5 weeks, bone remodeling began. Clinically, all four patients had successful RFA and vertebroplasty, with no neurological deficits. The pain scores were significanlty (P < 0.05) improved before (4.5–10, mean 8.0) compared with at four weeks (0–1.8, mean 1.8).ConclusionThe clustered electrode can be efficiently and safely applied in the treatment of spinal tumors without damaging the spinal cord and adjacent nerves by heat distribution.

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Efficacy of single fraction conventional radiation therapy for painful uncomplicated bone metastases: a systematic review and meta-analysis

Abstract: RFA assisted VP and OP using a bipolar device is safe and allows for controlled injection of cement into a preformed thermal cavity with a significant decrease in venous and posterior cement leaks. Rate of cement leakage into the disc spaces was unaffected.

Cited by 29 publications

References 0 publications

Clinical efficacy and safety of bone cement combined with radiofrequency ablation in the treatment of spinal metastases

Clinical efficacy and safety of bone cement combined with radiofrequency ablation in the treatment of spinal metastases

Analgesia from percutaneous thermal ablation plus cementoplasty for cancer bone metastases

Thermal effect of percutaneous radiofrequency ablation with a clustered electrode for vertebral tumors: In vitro and vivo experiments and clinical application

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