Radiographic Local Tumor Control and Pain Palliation of Sarcoma Metastases within the Musculoskeletal System with Percutaneous Thermal Ablation

Vaswani, Devin; Wallace, Adam N.; Eiswirth, Preston; Madaelil, Thomas P; Chang, Randy O.; Tomasian, Anderanik; Jennings, Jack W.

doi:10.1007/s00270-018-1932-1

Cited by 24 publications

(12 citation statements)

References 29 publications

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“…A retrospective analysis by Vaswani et al [ 79 ] of 64 bone metastases from sarcoma in 41 patients treated with ablation between December 2011 and August 2016 was performed. Two subgroups were treated: oligometastatic disease ( n = 13) and extensively metastatic disease ( n = 51).…”

Section: Literature Search Strategy and Results—interventional Strate...mentioning

confidence: 99%

Interventional Radiology in the Management of Metastases and Bone Tumors

Sgalambro

Zugaro

Bruno

et al. 2022

JCM

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Interventional Radiology (IR) has experienced an exponential growth in recent years. Technological advances of the last decades have made it possible to use new treatments on a larger scale, with good results in terms of safety and effectiveness. In musculoskeletal field, painful bone metastases are the most common target of IR palliative treatments; however, in selected cases of bone metastases, IR may play a curative role, also in combination with other techniques (surgery, radiation and oncology therapies, etc.). Primary malignant bone tumors are extremely rare compared with secondary bone lesions: osteosarcoma, Ewing sarcoma, and chondrosarcoma are the most common; however, the role of interventional radiology in this fiels is marginal. In this review, the main techniques used in interventional radiology were examined, and advantages and limitations illustrated. Techniques of ablation (Radiofrequency, Microwaves, Cryoablation as also magnetic resonance imaging-guided high-intensity focused ultrasound), embolization, and Cementoplasty will be described. The techniques of ablation work by destruction of pathological tissue by thermal energy (by an increase of temperature up to 90 °C with the exception of the Cryoablation that works by freezing the tissue up to −40 °C). Embolization creates an ischemic necrosis by the occlusion of the arterial vessels that feed the tumor. Finally, cementoplasty has the aim of strengthening bone segment weakened by the growth of pathological tissue through the injection of cement. The results of the treatments performed so far were also assessed and presented focused the attention on the management of bone metastasis.

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Section: Literature Search Strategy and Results—interventional Strate...mentioning

confidence: 99%

Interventional Radiology in the Management of Metastases and Bone Tumors

Sgalambro

Zugaro

Bruno

et al. 2022

JCM

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“…Within the given limits of the absence of a distinction among the type of ablative technique used, the numerical pain-rating scale at 32 months of follow-up was 2 ± 2 vs. 5 ± 1 at the baseline ( p < 0.001) and 3/7 metastases (43%) treated for local tumor control showed progression during follow-up, suggesting that percutaneous ablation allows significant long-lasting pain control, but sub-optimal LTC. Similarly, Vaswani et al [ 101 ] evaluated the effectiveness of RFA and CA in achieving local tumor control and pain palliation of sarcoma metastases in 64 patients, of which 13/64 with oligometastatic disease and 51/64 with widespread metastases. Thirty-one patients underwent CA, while 33 RFA and 27 ablated tumors were treated with adjunctive cementoplasty.…”

Section: Cryoablationmentioning

confidence: 99%

Minimally Invasive Interventional Procedures for Metastatic Bone Disease: A Comprehensive Review

Papalexis¹,

Parmeggiani²,

Peta³

et al. 2022

Current Oncology

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Metastases are the main type of malignancy involving bone, which is the third most frequent site of metastatic carcinoma, after lung and liver. Skeletal-related events such as intractable pain, spinal cord compression, and pathologic fractures pose a serious burden on patients’ quality of life. For this reason, mini-invasive treatments for the management of bone metastases were developed with the goal of pain relief and functional status improvement. These techniques include embolization, thermal ablation, electrochemotherapy, cementoplasty, and MRI-guided high-intensity focused ultrasound. In order to achieve durable pain palliation and disease control, mini-invasive procedures are combined with chemotherapy, radiation therapy, surgery, or analgesics. The purpose of this review is to summarize the recently published literature regarding interventional radiology procedures in the treatment of cancer patients with bone metastases, focusing on the efficacy, complications, local disease control and recurrence rate.

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“…54 In clinical practice, we recommend ablation of the entire volume of hyperintensity on fluid-sensitive and contrastenhanced MRI sequences plus ablation of at least an additional 3-mm margin to account for microscopic tumor spread and support improved patient outcomes. 55,56 Disadvantages of RFA include CT-occult ablation zone, heat sink effect particularly with hypervascular metastases, relative ineffectiveness for the treatment of osteoblastic tumors, relative contraindication for use of monopolar electrodes in patients with metallic implants and pacemakers due to risk of skin thermal injury and pacemaker dysfunction, intraprocedural pain, and, at times, increased pain during the immediate postablation period. 10,12,13,21,22 In a systematic review and meta-analysis for effectiveness of RFA (combined with cementation) for the treatment of painful osseous metastases comprising 426 patients (14 studies), investigators demonstrated statistically significant pain palliation following RFA.…”

Section: Radiofrequency Ablationmentioning

confidence: 99%

Interventional Palliation of Painful Extraspinal Musculoskeletal Metastases

Tomasian

Jennings

2022

Semin intervent Radiol

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The musculoskeletal system is commonly involved by metastases, and skeletal-related events such as intractable pain due to direct osseous tumor involvement, pathologic fracture, and neurologic deficits as a result of nerve compression often adversely affect patient's quality of life. There have been substantial advances in percutaneous minimally invasive musculoskeletal oncologic interventions for the management of patients with musculoskeletal metastases including thermal ablations, cementation with or without osseous reinforcement via implants, osteosynthesis, neurolysis, and palliative injections which are progressively incorporated in clinical practice. These interventions are performed, in conjunction with or supplemented by adjuvant radiation therapy, systemic therapy, surgery, or analgesics, to achieve durable pain palliation, local tumor control, or cure. This article reviews minimally invasive percutaneous image-guided musculoskeletal oncologic interventions for the management of patients with extraspinal musculoskeletal metastases.

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Radiographic Local Tumor Control and Pain Palliation of Sarcoma Metastases within the Musculoskeletal System with Percutaneous Thermal Ablation

Abstract: Level 4, Retrospective Review.

Cited by 24 publications

References 29 publications

Interventional Radiology in the Management of Metastases and Bone Tumors

Interventional Radiology in the Management of Metastases and Bone Tumors

Minimally Invasive Interventional Procedures for Metastatic Bone Disease: A Comprehensive Review

Interventional Palliation of Painful Extraspinal Musculoskeletal Metastases

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