Percutaneous Cementoplasty in the Palliative, Multimodal Treatment of Primary Bone Tumors of the Distal Aspect of the Radius in Four Dogs

Abstract

PC might be a useful addition to established palliative, multimodal treatment protocols in dogs with PBT; however, because of the complications encountered PC warrants further study before routine use can be considered.

Computed tomography-guided cementoplasty combined with radiation therapy for an aneurysmal bone cyst in a dog: a case report

“…The polymethylmethacrylate-related thermal effect is a main factor in the local control of the lesions (Sarierler et al 2004;Seegenschmiedt 2008) because cementoplasty, combined with megavoltage radiotherapy, achieves local control of the ABC, pain relief and thickening of the cortical bone, which can lead to strengthening of the bone. A similar multimodal protocol can be used to treat other bone tumours, such as alleviation of the pain of osteosarcoma (Boettcher et al 2009;Vignoli et al 2011). The use of a multimodal treatment protocol for osteosarcoma using palliative radiotherapy, chemotherapy, pamidronate and cementoplasty under fluoroscopic guidance led to a number of complications during the treatment, including cement leakage, wound infection and suspected thromboembolism (Boettcher et al 2009).…”

“…A similar multimodal protocol can be used to treat other bone tumours, such as alleviation of the pain of osteosarcoma (Boettcher et al 2009;Vignoli et al 2011). The use of a multimodal treatment protocol for osteosarcoma using palliative radiotherapy, chemotherapy, pamidronate and cementoplasty under fluoroscopic guidance led to a number of complications during the treatment, including cement leakage, wound infection and suspected thromboembolism (Boettcher et al 2009). Only minimal cement leakage was seen in our case.…”

“…Some reports have described progressive thickening of the cortical bone involving the cement, suggesting that the mechanical strength of the bone cement can be increased by bone formation (Sarierler et al 2004). Pain relief may be achieved by stabilising the bone and destroying the nerve terminals with polymethylmethacrylate because of the thermal heat and cytotoxic effects (Boettcher et al 2009). The polymethylmethacrylate-related thermal effect is a main factor in the local control of the lesions (Sarierler et al 2004;Seegenschmiedt 2008) because cementoplasty, combined with megavoltage radiotherapy, achieves local control of the ABC, pain relief and thickening of the cortical bone, which can lead to strengthening of the bone.…”

“…In this case, a total dose of 30 Gy, divided into 10 fractions of 3 Gy (five days a week), using a 12 MeV electron field was prescribed. Radiotherapy is effective both at alleviating the pain associated with the lesion and local control of the tumour (Feigenberg et al 2001;Boettcher et al 2009). One study showed that after the cystic cavity ossifies, its size does not change considerably and it never appears normal again (Feigenberg et al 2001).…”

“…The bone cement usually leads to instant, long-lasting, strong pain relief (Boettcher et al 2009). Cementation will also release some of the mechanical stress and prevent pathological fractures in a bone already predisposed by the osteolytic lesion (Sarierler et al 2004;Hosoya et al 2008).…”