RSS-Feed abonnieren
DOI: 10.1055/s-0037-1608747
Metastatic Osseous Pain Control: Bone Ablation and Cementoplasty
Publikationsverlauf
Publikationsdatum:
14. Dezember 2017 (online)
![](https://www.thieme-connect.de/media/sir/201704/lookinside/thumbnails/10-1055-s-0037-1608747_001034-1.jpg)
Abstract
Nociceptive and/or neuropathic pain can be present in all phases of cancer (early and metastatic) and are not adequately treated in 56 to 82.3% of patients. In these patients, radiotherapy achieves overall pain responses (complete and partial responses combined) up to 60 and 61%. On the other hand, nowadays, ablation is included in clinical guidelines for bone metastases and the technique is governed by level I evidence. Depending on the location of the lesion in the peripheral skeleton, either the Mirels scoring or the Harrington (alternatively the Levy) grading system can be used for prophylactic fixation recommendation. As minimally invasive treatment options may be considered in patients with poor clinical status or limited life expectancy, the aim of this review is to detail the techniques proposed so far in the literature and to report the results in terms of safety and efficacy of ablation and cementoplasty (with or without fixation) for bone metastases. Percutaneous image-guided treatments appear as an interesting alternative for localized metastatic lesions of the peripheral skeleton.
-
References
- 1 Coleman R, Body JJ, Aapro M, Hadji P, Herrstedt J. ; ESMO Guidelines Working Group. Bone health in cancer patients: ESMO Clinical Practice Guidelines. Ann Oncol 2014; 25 (03) 124-137
- 2 Ripamonti CI, Santini D, Maranzano E, Berti M, Roila F. ; ESMO Guidelines Working Group. Management of cancer pain: ESMO Clinical Practice Guidelines. Ann Oncol 2012; 23 (07) 139-154
- 3 Dennis K, Makhani L, Zeng L, Lam H, Chow E. Single fraction conventional external beam radiation therapy for bone metastases: a systematic review of randomised controlled trials. Radiother Oncol 2013; 106 (01) 5-14
- 4 Chow E, DeAngelis C, Chen BE. , et al. Effect of re-irradiation for painful bone metastases on urinary markers of osteoclast activity (NCIC CTG SC.20U). Radiother Oncol 2015; 115 (01) 141-148
- 5 Rosenthal D, Callstrom MR. Critical review and state of the art in interventional oncology: benign and metastatic disease involving bone. Radiology 2012; 262 (03) 765-780
- 6 Filippiadis DK, Tutton S, Kelekis A. Percutaneous bone lesion ablation. Radiol Med (Torino) 2014; 119 (07) 462-469
- 7 Filippiadis DK, Tutton S, Mazioti A, Kelekis A. Percutaneous image-guided ablation of bone and soft tissue tumours: a review of available techniques and protective measures. Insights Imaging 2014; 5 (03) 339-346
- 8 Gangi A, Tsoumakidou G, Buy X, Quoix E. Quality improvement guidelines for bone tumour management. Cardiovasc Intervent Radiol 2010; 33 (04) 706-713
- 9 Mirels H. Metastatic disease in long bones. A proposed scoring system for diagnosing impending pathologic fractures. Clin Orthop Relat Res 1989; (249) 256-264
- 10 Harrington KD. The management of acetabular insufficiency secondary to metastatic malignant disease. J Bone Joint Surg Am 1981; 63 (04) 653-664
- 11 Levy RN, Sherry HS, Siffert RS. Surgical management of metastatic disease of bone at the hip. Clin Orthop Relat Res 1982; (169) 62-69
- 12 Deschamps F, Farouil G, Hakime A. , et al. Cementoplasty of metastases of the proximal femur: is it a safe palliative option?. J Vasc Interv Radiol 2012; 23 (10) 1311-1316
- 13 Anselmetti GC, Manca A, Ortega C, Grignani G, Debernardi F, Regge D. Treatment of extraspinal painful bone metastases with percutaneous cementoplasty: a prospective study of 50 patients. Cardiovasc Intervent Radiol 2008; 31 (06) 1165-1173
- 14 Kelekis A, Lovblad KO, Mehdizade A. , et al. Pelvic osteoplasty in osteolytic metastases: technical approach under fluoroscopic guidance and early clinical results. J Vasc Interv Radiol 2005; 16 (01) 81-88
- 15 Dayer R, Peter R. Percutaneous cementoplasty complicating the treatment of a pathologic subtrochanteric fracture: a case report. Injury 2008; 39 (07) 801-804
- 16 Chang SW, Murphy KP. Percutaneous CT-guided cementoplasty for stabilization of a femoral neck lesion. J Vasc Interv Radiol 2005; 16 (06) 889-890
- 17 Basile A, Giuliano G, Scuderi V. , et al. Cementoplasty in the management of painful extraspinal bone metastases: our experience. Radiol Med (Torino) 2008; 113 (07) 1018-1028
- 18 Deschamps F, Farouil G, Hakime A, Teriitehau C, Barah A, de Baere T. Percutaneous stabilization of impending pathological fracture of the proximal femur. Cardiovasc Intervent Radiol 2012; 35 (06) 1428-1432
- 19 Kelekis A, Filippiadis D, Anselmetti G. , et al. Percutaneous augmented peripheral osteoplasty in long bones of oncologic patients for pain reduction and prevention of impeding pathologic fracture: the Rebar concept. Cardiovasc Intervent Radiol 2016; 39 (01) 90-96
- 20 Tian Q-H, He C-J, Wu C-G. , et al. Comparison of percutaneous cementoplasty with and without interventional internal fixation for impending malignant pathological fracture of the proximal femur. Cardiovasc Intervent Radiol 2016; 39 (01) 81-89
- 21 Kelekis AD, Somon T, Yilmaz H. , et al. Interventional spine procedures. Eur J Radiol 2005; 55 (03) 362-383
- 22 Tsoumakidou G, Garnon J, Ramamurthy N, Buy X, Gangi A. Interest of electrostimulation of peripheral motor nerves during percutaneous thermal ablation. Cardiovasc Intervent Radiol 2013; 36 (06) 1624-1628
- 23 Motamedi K, Levine BD, Bukata SV, Genshaft S. Percutaneous image-guided musculoskeletal tumor treatments. AJR Am J Roentgenol 2016; 207 (03) 517-525
- 24 Callstrom MR, Charboneau JW, Goetz MP. , et al. Painful metastases involving bone: feasibility of percutaneous CT- and US-guided radio-frequency ablation. Radiology 2002; 224 (01) 87-97
- 25 Carrafiello G, Laganà D, Ianniello A. , et al. Radiofrequency thermal ablation for pain control in patients with single painful bone metastasis from hepatocellular carcinoma. Eur J Radiol 2009; 71 (02) 363-368
- 26 Dupuy DE, Liu D, Hartfeil D. , et al. Percutaneous radiofrequency ablation of painful osseous metastases: a multicenter American College of Radiology Imaging Network trial. Cancer 2010; 116 (04) 989-997
- 27 Goetz MP, Callstrom MR, Charboneau JW. , et al. Percutaneous image-guided radiofrequency ablation of painful metastases involving bone: a multicenter study. J Clin Oncol 2004; 22 (02) 300-306
- 28 Hong K, Georgiades CS. Radiofrequency ablation: mechanism of action and devices. In: Hong K, Georgiades CS. , ed. Percutaneous Tumor Ablation: Strategies and Techniques. New York, NY: Thieme; 2011: 1-14
- 29 Rosenthal DI, Alexander A, Rosenberg AE, Springfield D. Ablation of osteoid osteomas with a percutaneously placed electrode: a new procedure. Radiology 1992; 183 (01) 29-33
- 30 Georgiades CS, Marx JK. Cryoablation: mechanism of action and devices. In: Hong K, Georgiades CS. , ed. Percutaneous Tumor Ablation: Strategies and Techniques. New York, NY: Thieme; 2011: 15-26
- 31 Littrup PJ, Bang HJ, Currier BP. , et al. Soft-tissue cryoablation in diffuse locations: feasibility and intermediate term outcomes. J Vasc Interv Radiol 2013; 24 (12) 1817-1825
- 32 Callstrom MR, Dupuy DE, Solomon SB. , et al. Percutaneous image-guided cryoablation of painful metastases involving bone: multicenter trial. Cancer 2013; 119 (05) 1033-1041
- 33 Lubner MG, Brace CL, Hinshaw JL, Lee Jr FT. Microwave tumor ablation: mechanism of action, clinical results, and devices. J Vasc Interv Radiol 2010; 21 (8, Suppl): S192-S203
- 34 Amabile C, Ahmed M, Solbiati L. , et al. Microwave ablation of primary and secondary liver tumours: ex vivo, in vivo, and clinical characterisation. Int J Hyperthermia 2017; 33 (01) 34-429
- 35 Pusceddu C, Sotgia B, Fele RM, Melis L. Treatment of bone metastases with microwave thermal ablation. J Vasc Interv Radiol 2013; 24 (02) 229-233
- 36 Kastler A, Alnassan H, Aubry S, Kastler B. Microwave thermal ablation of spinal metastatic bone tumors. J Vasc Interv Radiol 2014; 25 (09) 1470-1475
- 37 Hinshaw JL, Lubner MG, Ziemlewicz TJ, Lee Jr FT, Brace CL. Percutaneous tumor ablation tools: microwave, radiofrequency, or cryoablation--what should you use and why?. Radiographics 2014; 34 (05) 1344-1362
- 38 Gangi A, Tsoumakidou G, Buy X, Garnon J, Sabharwal T, Douarte R. Percutaneous bone treatment management. In: Mueller PR, Adam A. , eds. Interventional Oncology; A Practical Guide for the Interventional Radiologist. New York, NY: Springer; 2012: 169-183
- 39 Napoli A, Anzidei M, Marincola BC. , et al. MR imaging-guided focused ultrasound for treatment of bone metastasis. Radiographics 2013; 33 (06) 1555-1568
- 40 Nielsen OS, Munro AJ, Tannock IF. Bone metastases: pathophysiology and management policy. J Clin Oncol 1991; 9 (03) 509-524
- 41 Hellman S, Weichselbaum RR. Oligometastases. J Clin Oncol 1995; 13 (01) 8-10
- 42 McMenomy BP, Kurup AN, Johnson GB. , et al. Percutaneous cryoablation of musculoskeletal oligometastatic disease for complete remission. J Vasc Interv Radiol 2013; 24 (02) 207-213
- 43 Weichselbaum RR, Hellman S. Oligometastases revisited. Nat Rev Clin Oncol 2011; 8 (06) 378-382
- 44 Kurup AN, Callstrom MR. Ablation of musculoskeletal metastases: pain palliation, fracture risk reduction, and oligometastatic disease. Tech Vasc Interv Radiol 2013; 16 (04) 253-261
- 45 Frassica DA. General principles of external beam radiation therapy for skeletal metastases. Clin Orthop Relat Res 2003; ;(415, Suppl): S158-S164
- 46 Lutz S, Chow E. A review of recently published radiotherapy treatment guidelines for bone metastases: contrasts or convergence?. J Bone Oncol 2012; 1 (01) 18-23
- 47 Vayne-Bossert P, Afsharimani B, Good P, Gray P, Hardy J. Interventional options for the management of refractory cancer pain--what is the evidence?. Support Care Cancer 2016; 24 (03) 1429-1438
- 48 Martin BC, Fan MY, Edlund MJ, Devries A, Braden JB, Sullivan MD. Long-term chronic opioid therapy discontinuation rates from the TROUP study. J Gen Intern Med 2011; 26 (12) 1450-1457
- 49 Ballantyne JC, Kalso E, Stannard C. WHO analgesic ladder: a good concept gone astray. BMJ 2016; 352: i20
- 50 Gangi A, Buy X. Percutaneous bone tumor management. Semin Intervent Radiol 2010; 27 (02) 124-136
- 51 Mercadante S. Malignant bone pain: pathophysiology and treatment. Pain 1997; 69 (1-2): 1-18
- 52 Callstrom MR, Atwell TD, Charboneau JW. , et al. Painful metastases involving bone: percutaneous image-guided cryoablation--prospective trial interim analysis. Radiology 2006; 241 (02) 572-580
- 53 Prologo JD, Passalacqua M, Patel I, Bohnert N, Corn DJ. Image-guided cryoablation for the treatment of painful musculoskeletal metastatic disease: a single-center experience. Skeletal Radiol 2014; 43 (11) 1551-1559
- 54 Wallace AN, McWilliams SR, Connolly SE. , et al. Percutaneous image-guided cryoablation of musculoskeletal metastases: pain palliation and local tumor control. J Vasc Interv Radiol 2016; 27 (12) 1788-1796
- 55 Kastler A, Alnassan H, Pereira PL. , et al. Analgesic effects of microwave ablation of bone and soft tissue tumors under local anesthesia. Pain Med 2013; 14 (12) 1873-1881
- 56 Kinczewski L. Microwave ablation for palliation of bone metastases. Clin J Oncol Nurs 2016; 20 (03) 249-252
- 57 Napoli A, Anzidei M, Marincola BC. , et al. Primary pain palliation and local tumor control in bone metastases treated with magnetic resonance-guided focused ultrasound. Invest Radiol 2013; 48 (06) 351-358
- 58 Yeo SY, Elevelt A, Donato K. , et al. Bone metastasis treatment using magnetic resonance-guided high intensity focused ultrasound. Bone 2015; 81: 513-523
- 59 National Comprehensive Cancer Network. Adult Cancer Pain v. 2; 2016. Available at: https://www.nccn.org/professionals/physician_gls/f_guidelines.asp . Accessed November 21, 2016
- 60 Tomasian A, Wallace AN, Hillen TJ, Jennings JW. Percutaneous ablation in painful bone tumors. Semin Musculoskelet Radiol 2016; 20 (05) 472-485
- 61 Nazario J, Hernandez J, Tam AL. Thermal ablation of painful bone metastases. Tech Vasc Interv Radiol 2011; 14 (03) 150-159
- 62 Kurup AN, Schmit GD, Morris JM. , et al. Avoiding complications in bone and soft tissue ablation. Cardiovasc Intervent Radiol 2017; 40 (02) 166-176
- 63 Kurup AN, Morris JM, Boon AJ. , et al. Motor evoked potential monitoring during cryoablation of musculoskeletal tumors. J Vasc Interv Radiol 2014; 25 (11) 1657-1664
- 64 Cazzato RL, Palussière J, Buy X. , et al. Percutaneous long bone cementoplasty for palliation of malignant lesions of the limbs: a systematic review. Cardiovasc Intervent Radiol 2015; 38 (06) 1563-1572
- 65 Saha S, Pal S. Mechanical properties of bone cement: a review. J Biomed Mater Res 1984; 18 (04) 435-462
- 66 Lewis G. Properties of acrylic bone cement: state of the art review. J Biomed Mater Res 1997; 38 (02) 155-182
- 67 Deschamps F, de Baere T, Hakime A. , et al. Percutaneous osteosynthesis in the pelvis in cancer patients. Eur Radiol 2016; 26 (06) 1631-1639
- 68 Garnon J, Koch G, Ramamurthy N. , et al. Percutaneous CT and fluoroscopy-guided screw fixation of pathological fractures in the shoulder girdle: technical report of 3 cases. Cardiovasc Intervent Radiol 2016; 39 (09) 1332-1338
- 69 Kelekis A, Filippiadis DK, Kelekis NL, Martin JB. Percutaneous augmented osteoplasty of the humeral bone using a combination of microneedles mesh and cement. J Vasc Interv Radiol 2015; 26 (04) 595-597
- 70 Kelekis A, Martin JB, Anselmetti G, Filipiadis D. Regarding “percutaneous augmented peripheral osteoplasty in long bones of oncologic patients for pain reduction and prevention of impeding pathologic fracture: the Rebar concept”: reply. Cardiovasc Intervent Radiol 2016; 39 (03) 479-480
- 71 Cornelis FH, Tselikas L, Carteret T. , et al. A novel implant for the prophylactic treatment of impending pathological fractures of the proximal femur: results from a prospective, first-in-man study. Cardiovasc Intervent Radiol 2017; 40 (07) 1070-1076
- 72 Szpalski M, Gunzburg R, Aebi M. , et al. A new approach to prevent contralateral hip fracture: Evaluation of the effectiveness of a fracture preventing implant. Clin Biomech (Bristol, Avon) 2015; 30 (07) 713-719
- 73 Beckmann J, Springorum R, Vettorazzi E. , et al. Fracture prevention by femoroplasty--cement augmentation of the proximal femur. J Orthop Res 2011; 29 (11) 1753-1758
- 74 Nakata K, Kawai N, Sato M. , et al. Bone marrow nails created by percutaneous osteoplasty for long bone fracture: comparisons among acrylic cement alone, acrylic-cement-filled bare metallic stent, and acrylic-cement-filled covered metallic stent. Cardiovasc Intervent Radiol 2011; 34 (03) 609-614
- 75 Nakata K, Kawai N, Sato M. , et al. Percutaneous osteoplasty with a bone marrow nail for fractures of long bones: experimental study. J Vasc Interv Radiol 2010; 21 (09) 1436-1441
- 76 Munk PL, Rashid F, Heran MK. , et al. Combined cementoplasty and radiofrequency ablation in the treatment of painful neoplastic lesions of bone. J Vasc Interv Radiol 2009; 20 (07) 903-911
- 77 Toyota N, Naito A, Kakizawa H. , et al. Radiofrequency ablation therapy combined with cementoplasty for painful bone metastases: initial experience. Cardiovasc Intervent Radiol 2005; 28 (05) 578-583
- 78 Proschek D, Kurth A, Proschek P, Vogl TJ, Mack MG. Prospective pilot-study of combined bipolar radiofrequency ablation and application of bone cement in bone metastases. Anticancer Res 2009; 29 (07) 2787-2792
- 79 Pusceddu C, Sotgia B, Fele RM, Ballicu N, Melis L. Combined microwave ablation and cementoplasty in patients with painful bone metastases at high risk of fracture. Cardiovasc Intervent Radiol 2016; 39 (01) 74-80