Efficacy of Cryoablation to Control Cancer Pain: A Systematic Review

Ferrer-Mileo, Laura; Blanco, Ana Isabel Luque; González‐Barboteo, Jesús

doi:10.1111/papr.12707

Cited by 21 publications

(27 citation statements)

References 40 publications

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“…Quality of life parameters were improved, and functional status was preserved through the 6 months of follow-up. These results support the findings of prior retrospective and prospective studies that have demonstrated cryoablation provides rapid and durable nonopioid pain relief and opiate reduction in patients with painful metastatic disease to the bone (14,16,(18)(19)(20)(21). Notably, these findings are in line with the largest reported prospective study that included 69 metastatic bone tumors from 61 patients who were treated with cryoablation, which found that the mean score for worst pain in the past 24-hour period, scored using the BPI-SF, decreased from 7.1 prior to cyroablation to 5.1 1 week after treatment to 1.4 at 24 weeks after treatment (P , .0001) (19).…”

Section: Discussionsupporting

confidence: 88%

Cryoablation for Palliation of Painful Bone Metastases: The MOTION Multicenter Study

Jennings¹,

Prologo²,

Garnon³

et al. 2021

Radiology: Imaging Cancer

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To assess the clinical effectiveness of cryoablation for palliation of painful bone metastases. Materials and Methods: MOTION (Multicenter Study of Cryoablation for Palliation of Painful Bone Metastases) (ClinicalTrials.gov NCT 02511678) was a multicenter, prospective, single-arm study of adults with metastatic bone disease who were not candidates for or had not benefited from standard therapy, that took place from February 2016 to March 2018. At baseline, participants rated their pain using the Brief Pain Inventory-Short Form (reference range from 0 to 10 points); those with moderate to severe pain, who had at least one metastatic candidate tumor for ablation, were included. The primary effectiveness endpoint was change in pain score from baseline to week 8. Participants were followed for 24 weeks after treatment. Statistical analyses included descriptive statistics and logistic regression to evaluate changes in pain score over the postprocedure follow-up period. Results: A total of 66 participants (mean age, 60.8 years 6 14.3 [standard deviation]; 35 [53.0%] men) were enrolled and received cryoablation; 65 completed follow-up. Mean change in pain score from baseline to week 8 was 22.61 points (95% CI: 23.45, 21.78). Mean pain scores improved by 2 points at week 1 and reached clinically meaningful levels (more than a 2-point decrease) after week 8; scores continued to improve throughout follow-up. Quality of life improved, opioid doses were stabilized, and functional status was maintained over 6 months. Serious adverse events occurred in three participants. Conclusion: Cryoablation of metastatic bone tumors provided rapid and durable pain palliation, improved quality of life, and offered an alternative to opioids for pain control.

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Section: Discussionsupporting

confidence: 88%

Cryoablation for Palliation of Painful Bone Metastases: The MOTION Multicenter Study

Jennings¹,

Prologo²,

Garnon³

et al. 2021

Radiology: Imaging Cancer

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“…In Denmark, surgical resection is still considered the preferred treatment of solitary metastatic RCC 3. This in line with cryoablation historically being favoured by the elderly and comorbid patients 10. Cases like this could be the beginning of a paradigm shift but recurrence and incomplete treatment are a concern.…”

Section: Discussionmentioning

confidence: 69%

“…The available evidence on cryoablation used as pain control is limited. But a recently published systematic review suggests that cryoablation is effective in controlling cancer pain, without relevant adverse effects 10…”

Section: Discussionmentioning

confidence: 99%

Percutaneous cryoablation of a solitary, soft-tissue metastasis from renal cell carcinoma: a new local minimal invasive curative treatment

et al. 2019

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Cryoablation is a well-established treatment option, proven to be successful in treating local renal cell carcinoma (RCC). We treated a 67-year-old man in an outpatient setting with late onset of a 25 mm solitary soft-tissue metastasis of from RCC with cryoablation. The treatment was performed under sedation and in local anaesthesia. There were no complications during the procedure. The patient did not experience any adverse effects to the treatment. He was able to resume his normal daily routines the day after his treatment. A follow-up CT scan at 3, 8 and 12 months after treatment reported sufficient cryoablation and no sign of recurrence or other metastases.

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“…PCA has become an established treatment option in the management of a number of tumors, like renal or hepatocellular carcinomas, and for tumors of limited size, it can be considered as an alternative to surgery 17,18 . PCA is also frequently used for pain control, especially in the setting of advanced cancer 19,20 …”

Section: Introductionmentioning

confidence: 99%

“…17,18 PCA is also frequently used for pain control, especially in the setting of advanced cancer. 19,20 This retrospective analysis evaluated the outcome in all patients treated by PCA in our sarcoma center for unresectable sacral primary-or loco-regionally recurrent chordoma, with a minimal 5 years follow-up.…”

mentioning

confidence: 99%

Image‐guided percutaneous cryoablation of unresectable sacrococcygeal chordoma: Feasibility and outcome in a selected group of patients with long term follow‐up

Cherix

Traverso

Bazan

et al. 2020

Journal of Surgical Oncology

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BackgroundChordoma is a rare malignant tumor of the axial skeleton. Percutaneous cryoablation (PCA) is a minimally invasive technique that allows freezing of tumors under imaging control. The purpose of our retrospective study was to investigate the outcome of PCA in a selected cohort of patients with sacrococcygeal chordoma, with a minimum of 5 years follow‐up.Materials and MethodsFour patients were treated in 10 sessions. The mean follow‐up was 57.3 months. We evaluated the feasibility, the procedure‐related complications, the impact on pain control and oncological outcomes.ResultsFreezing of 100% of the tumor volume was possible in 60%. Pain control was not reliably evaluable. Local recurrence occurred in 90% of the treated lesions; the mean time to progression was 8.1 months (range 1.5–16). At last follow‐up, one patient had died of the disease, one of another cause and one was receiving the best supportive care. The only patient alive without the disease had received additional carbon‐ion radiotherapy. The 5‐year survival rate after index PCA was 50%.ConclusionComplete freezing of the tumor was technically challenging, mainly due to the complex local anatomy. Recurrence occurred in 90% of the lesions treated. PCA should be considered with caution in the curative management of sacrococcygeal chordoma.

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Efficacy of Cryoablation to Control Cancer Pain: A Systematic Review

Abstract: Cryoablation is effective in controlling cancer pain without relevant side effects. However, more studies are needed to confirm these results.

Cited by 21 publications

References 40 publications

Cryoablation for Palliation of Painful Bone Metastases: The MOTION Multicenter Study

Cryoablation for Palliation of Painful Bone Metastases: The MOTION Multicenter Study

Percutaneous cryoablation of a solitary, soft-tissue metastasis from renal cell carcinoma: a new local minimal invasive curative treatment

Image‐guided percutaneous cryoablation of unresectable sacrococcygeal chordoma: Feasibility and outcome in a selected group of patients with long term follow‐up

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