Percutaneous ablation of bone tumors

Area of Science:

• Oncology
• Interventional Radiology
• Orthopedic Oncology

Background:

• Percutaneous ablation (radiofrequency, cryotherapy) is primarily used for palliative bone tumor treatment.
• Studies confirm its efficacy in reducing pain from bone metastases, offering an alternative to radiotherapy and opioids.
• Curative applications are less studied, with notable exceptions like radiofrequency ablation for osteoid osteomas (nearly 100% success).

Purpose of the Study:

• To evaluate the efficacy of percutaneous ablation for bone metastases, considering both palliative and curative intentions.
• To assess the impact of metastasis size on radiofrequency ablation success rates.
• To determine the role of cementoplasty in conjunction with ablation for lytic bone metastases.

Main Methods:

• Review of percutaneous ablation techniques (radiofrequency, cryotherapy) for bone tumors.
• Analysis of success rates based on metastasis size (specifically <3cm vs. larger).
• Consideration of adjuvant cementoplasty for lytic lesions to prevent fractures.

Main Results:

• Percutaneous ablation significantly reduces symptoms of painful bone metastases.
• Radiofrequency ablation success rate is 75% for metastases <3cm, decreasing to 40% for larger lesions (P=0.04).
• Treatment may be suitable for slowly progressing oligometastatic disease, though survival benefit is unassessed.

Conclusions:

• Percutaneous ablation is effective for palliation and potentially for select curative cases of bone metastases.
• Tumor size is a critical factor influencing radiofrequency ablation outcomes.
• Consolidation with cementoplasty is recommended for lytic metastases to mitigate fracture risk.