Image-guided palliation of painful metastases using percutaneous ablation

Painful skeletal metastases are a common problem in cancer patients. Although external beam radiation therapy is the current standard of care for cancer patients who present with localized bone pain, 20 to 30% of patients treated with this modality do not experience pain relief and few further options exist for these patients. For many patients with painful metastatic skeletal disease, analgesics remain the only alternative treatment option. Recently, image-guided percutaneous methods of tumor destruction have proven effective for treatment of this difficult problem. Patient selection, treatment methods, and results of treatment are described for the use of percutaneous radiofrequency ablation and cryoablation for patients with painful metastatic disease.