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Cryoablation for Palliation of Painful Bone Metastases: The MOTION Multicenter Study
Jack W Jennings1, J David Prologo1, Julien Garnon1
1Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Box 8131, St Louis, MO 63110 (J.W.J.); Division of Interventional Radiology and Image-Guided Medicine, Emory University School of Medicine, Atlanta, Ga (J.D.P.); Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France (J.G., A.G.); Department of Radiology, Institut Bergonié, Bordeaux, France (X.B., J.P.); Department of Radiology, Mayo Clinic, Rochester, Minn (A.N.K., M.C.); Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, Calif (S.G., F.A.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.J.H.); Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (J.I.); Departments of Radiology (F.P) and Interventional Radiology (C.M.), Centre Léon Bérard, Lyon, France; Department of Radiology, Ascension Providence Rochester Hospital, Rochester, Mich (P.J.L.); and Department of Interventional Radiology, Institut Gustave Roussy, Villejuif, France (T.d.B., F.D.).
Purpose:
To assess the clinical effectiveness of cryoablation for palliation of painful bone metastases.
Materials And Methods:
MOTION (Multicenter Study of Cryoablation for Palliation of Painful Bone Metastases) (ClinicalTrials.gov NCT02511678) was a multicenter, prospective, single-arm study of adults with metastatic bone disease who were not candidates for or had not benefited from standard therapy, that took place from February 2016 to March 2018. At baseline, participants rated their pain using the Brief Pain Inventory-Short Form (reference range from 0 to 10 points); those with moderate to severe pain, who had at least one metastatic candidate tumor for ablation, were included. The primary effectiveness endpoint was change in pain score from baseline to week 8. Participants were followed for 24 weeks after treatment. Statistical analyses included descriptive statistics and logistic regression to evaluate changes in pain score over the postprocedure follow-up period.
Results:
A total of 66 participants (mean age, 60.8 years ± 14.3 [standard deviation]; 35 [53.0%] men) were enrolled and received cryoablation; 65 completed follow-up. Mean change in pain score from baseline to week 8 was -2.61 points (95% CI: -3.45, -1.78). Mean pain scores improved by 2 points at week 1 and reached clinically meaningful levels (more than a 2-point decrease) after week 8; scores continued to improve throughout follow-up. Quality of life improved, opioid doses were stabilized, and functional status was maintained over 6 months. Serious adverse events occurred in three participants.
Conclusion:
Cryoablation of metastatic bone tumors provided rapid and durable pain palliation, improved quality of life, and offered an alternative to opioids for pain control.Keywords: Ablation Techniques, Metastases, Pain Management, Radiation Therapy/OncologySupplemental material is available for this article.© RSNA, 2021.
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