Masala S, Guglielmi G, Petrella MC, Mastrangeli R, Meschini A, Anselmetti GC, Bartolucci DA, Mammucari M, Manenti G, Simonetti G
Correspondence: Prof Giuseppe Guglielmi, g.guglielmi@unifg.it
ABSTRACT
Introduction The aim of this study was to examine the role of palliative percutaneous secondary lesions bone treatment by comparing the visual analogue scale (VAS) scores of cryoablation plus vertebroplasty versus radiofrequency (RF) plus vertebroplasty so as to determine their feasibility, reliability and efficacy in a short-term series.
Methods Combined RF thermal ablation plus osteoplasty or cryoablation plus osteoplasty was performed in osteolytic secondary bone localisations in 30 consecutive patients who were suffering from pain refractory to conservative therapies. We evaluated pain with the VAS during the preoperative period and at four hours, 24 hours, one week, one month, three months and six months post procedure.
Results There were no statistically significant differences in the VAS score between patients treated with cryoablation plus osteoplasty and those treated with RF ablation plus osteoplasty at one week (p-value is 0.34), one month (p-value is 1), three months (p-value is 0.68) and six months (p-value is 0.65) post procedure. Patients treated with cryoablation plus vertebroplasty have less pain at four hours (p-value less than 0.001) and 24 hours (p -value less than 0.001) than patients treated with RF ablation plus vertebroplasty.
Conclusion Both RF ablation and cryoablation are optimal techniques in the treatment of painful bone metastatic cancer. Cryoablation achieves less treatment-related pain during the early period of follow-up and better volume control by real-time depiction of ablation margins.
Keywords: bone metastases, cryoablation, percutaneous therapies, radiofrequency, vertebroplasty
Singapore Med J 2011; 52(3): 182-189