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Radiofrequency Ablation Eases Pain Caused by Bone Metastases: Presented at RSNA

By Ed Susman
Special to DG News

CHICAGO, IL -- December 5, 2002 -- Dramatic and durable pain relief is possible for patients with bone metastases by using by guiding needles to the site of the lesions through ultrasound or computed tomography and then heating the needles with radio frequency waves.

A multicenter, international study demonstrated dramatic reductions in pain and improved quality of life in patients, said Dr. Matthew R. Callstrom, MD, PhD, associate professor of radiology, Mayo Clinic, Rochester, Minnesota, United States, who presented the findings at here December 4 the at the 88^th Scientific Assembly and Annual Meeting of the Radiological Society of North America .

He said that prior to treatment the "average analog pain score for these patients was 8/10, while after treatment the average score was 2/10." The scores refer to the standardized Brief Pain Inventory in which "10" represents the highest level of pain and "0" represents no pain.

Dr. Callstrom said operators used percutaneous computed tomography or ultrasound to guide the probe. He said the best results are achieved when "the probe is guided through the tumor and we ablate right up against the bone." He added, "It isn't enough to simply ablate the lesion from the center."

All patients had one or two lesions and had either failed or were poor candidates for conventional radiation or chemotherapy. "One patient was a 29-year-old woman with a lesion in her shoulder. She faced radical surgery to lose the shoulder and arm. Using radiofrequency ablation we were able to ablate the lesion in about 10 minutes," said Dr. Callstrom.

In another case a man with a metastatic melanoma in the shin started with an average pain score of 7/10 but "the pain went to 0/0 after the ablation and this man was able to play racket ball."

Fifty of the 62 patients achieved a high degree of pain relief and 45 percent had complete pain remission during the six-month follow-up, he said.

Before the ablation pain "regularly interfered with daily activity, but after treatment patients were able to resume many activities. So this treatment, while not curative, restored a good quality of life for these patients," he said.

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