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RFA with cement augmentation safely and effectively reduces pain and disability rapidly, while increasing quality of life in patients suffering from vertebral body metastases.

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BPH ¼ benign prostatic hyperplasia, IIEF ¼ International Index of Erectile Function, IPSS ¼ International Prostate Symptom Score, LUTS ¼ lower urinary tract symptoms, MIST ¼ minimally invasive surgical therapies, OP ¼ open prostatectomy, PAE ¼ prostatic artery embolization, PVR ¼ postvoid residual, QOL ¼ quality of life, RCT ¼ randomized controlled trial, TURP ¼ transurethral resection of the prostate, UK-ROPE ¼ United Kingdom Register of Prostate Embolization BACKGROUND Benign prostatic hyperplasia (BPH) describes the proliferation of the glandular and stromal tissue in the transition zone of the prostate, which may result in bladder outlet obstruction and consequent lower urinary tract symptoms (LUTS). The prevalence of BPH increases with age, affecting more than 70% of men older than 70 years (1), and one fourth of men older than 70 years have moderate to severe LUTS that impair their quality of life (QOL) (2,3). Thus, BPH and ensuing LUTS represent a significant health issue affecting millions of men. The International Prostate Symptom Score (IPSS; also known as the American Urologic Association Symptom Index) is a validated instrument that quantifies a patient's subjective urinary symptoms on a 35-point scale (4). The IPSS also incorporates a urinary QOL score, which assesses how the patient feels overall about his urinary symptoms. Nearly all studies assessing BPH treatments for LUTS use the IPSS and QOL scores to assess patients before and after treatment. A 3-point change in IPSS is noticeable by a man with LUTS (5), and a 30% reduction in IPSS is considered clinically acceptable for a treatment to be considered effective (6,7). Medical therapies, including a-1 blockers and 5-a reductase inhibitors, are the mainstay of treatment for mild to moderate LUTS. The symptomatic relief is relatively modest, with IPSS improvement in the range of 3-7 points (8). Although generally considered safe, medical

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Purpose: To evaluate the effectiveness of radiofrequency (RF) ablation as measured by change in worst pain score from baseline to 3 mo after RF ablation for the palliative treatment of painful bone metastases.Materials and Methods: One hundred patients (mean age, 64.6 y) underwent RF ablation for metastatic bone disease and were followed up to 6 mo. Subjects' pain and quality of life were measured before RF ablation and postoperatively by using the Brief Pain Index and European Quality of Life questionnaires. Opioid agent use and device-, procedure-, and/or therapy-related adverse events (AEs) were collected.Results: Eighty-seven patients were treated for tumors involving the thoracolumbar spine and 13 for tumors located in the pelvis and/or sacrum. All ablations were technically successful, and 97% were followed by cementoplasty. Mean worst pain score decreased from 8.2 ± 1.7 at baseline to 3.5 ± 3.2 at 6 mo (n ¼ 22; P < 0.0001 for all visits). Subjects experienced significant improvement for all visits in average pain (P <.0001), pain interference (P < .0001), and quality of life (P < .003). Four AEs were reported, of which 2 resulted in hospitalization for pneumonia and respiratory failure. All 30 deaths reported during the study were attributed to the underlying malignancy and not related to the study procedure.Conclusions: Results from this study show rapid (within 3 d) and statistically significant pain improvement with sustained long-term relief through 6 mo in patients treated with RF ablation for metastatic bone disease.