Radiofrequency ablation of bone metastases provides pain relief

Radiofrequency ablation (RFA) provides significant and lasting pain relief in cancer patients with osteolytic bone metastases, according to a new study. All but 2 of 43 patients experienced a clinically significant decrease in pain beginning at 1 week and extending out to week 24, with highly significant reductions in worst pain, average pain, and pain interference.

External beam irradiation is the standard of care for patients with localized bone pain from metastatic cancer, the authors explain, but as many as 30% of patients do not experience pain relief from such treatment. The study is published in the January 15th Journal of Clinical Oncology.Dr. J. William Charboneau from Mayo Clinic, Rochester, Minnesota and colleagues treated 43 patients with painful osteolytic metastases involving bone using image-guided RFA and assessed the outcomes. All patients had either failed or were poor candidates for standard treatments, including radiation and opioid analgesics.The study design allowed treatment of only one lesion, the report indicates, and this required a median number of ablations of 3.0 per lesion, requiring a mean total ablation time of 49.5 minutes.”We limited the number of sites for the study to know for sure how effective the method was,” Dr. Charboneau told Reuters Health. “You could do several lesions, but it certainly would not work for wide-spread metastasis. There is a practical limit.”Opioid requirements fell after week 1, the results indicate, but increased again at week 24 despite the maintenance of lower pain scores.After accounting for missing data, the researchers determined that the data indicated continued improvement in pain relief in patients followed the longest, suggesting that the overall results represent a conservative estimate of the impact of the procedure.”RFA is a highly effective treatment to reduce severe bone pain from a limited number of metastases, and the duration of relief is long,” Dr. Charboneau said.(Source: J Clin Oncol 2004;22:300-306: Reuters Health: Will Boggs, MD: February 10, 2004: Oncolink)