Radiofrequency Ablation Effective in Reducing Pain from Bone Metastases

A new study reports that image-guided radiofrequency ablation (RFA) significantly reduced the level of pain experienced by cancer patients with osseous metastases, limiting the need for strong narcotic pain management.

Researchers at Rhode Island Hospital (RIH; Providence, USA) and Brown University (Providence, RI, USA) studied 55 patients who had a single painful bone metastasis. Each patient received computed tomography (CT) guided RFA of the bone metastasis to temperatures of over 60 degrees centigrade. Endpoints were the toxicity and pain effects of RFA pain prior to treatment, daily for two weeks following the procedure, and again at one month and three months after RFA. In all, 55 patients completed RFA.

The results showed that RFA reduced pain at 1 and 3 months for all pain assessment measures. The average increase in pain relief from pre-RFA to 1-month follow-up was 26.3 on a 1-100 scale, and the increase from pre-RFA to 3-month follow-up was 16. The average decrease in pain intensity from pre-RFA to 1-month follow-up was 26.9 and 14.2 for 3-month follow-up. Statistically significant pain reduction was evident in follow-ups for all pain assessment measurements: pain relief, intensity, and severity. In all cases, improvement was seen for each measurement, including patient mood, with the most improvement at the one-month interval. The study was published online ahead of print on December 29, 2009, in the journal Cancer.

"RFA is widely available, covered by most insurance, can be performed in a single outpatient session and often allows patients enhanced interaction with loved ones by reducing use of strong narcotics which can leave them in a medicated state,” said lead author Damian Dupuy, M.D, director of ablation services at RIH. "Also, unlike many other cancer pain management treatments, RFA can be repeated and maintain similar results.”

"Despite advances in radiation technology and development of new medical manipulations, too many cancer patients still experience pain associated with their disease,” said coauthor Thomas DiPetrillo, M.D., an associate professor of radiation oncology at Brown University. "This study demonstrates the palliative benefits of RFA with minimal treatment-related morbidity. Oncologists have another tool for the management of cancer pain.”

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Rhode Island Hospital
Brown University