Department of Interventional Radiology, Northside Hospital, Atlanta, Georgia.
Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina.
J Vasc Interv Radiol. 2020 Nov;31(11):1745-1752. doi: 10.1016/j.jvir.2020.07.014.
To evaluate the effectiveness of radiofrequency (RF) ablation as measured by change in worst pain score from baseline to 3 mo after RF ablation for the palliative treatment of painful bone metastases.
One hundred patients (mean age, 64.6 y) underwent RF ablation for metastatic bone disease and were followed up to 6 mo. Subjects' pain and quality of life were measured before RF ablation and postoperatively by using the Brief Pain Index and European Quality of Life questionnaires. Opioid agent use and device-, procedure-, and/or therapy-related adverse events (AEs) were collected.
Eighty-seven patients were treated for tumors involving the thoracolumbar spine and 13 for tumors located in the pelvis and/or sacrum. All ablations were technically successful, and 97% were followed by cementoplasty. Mean worst pain score decreased from 8.2 ± 1.7 at baseline to 3.5 ± 3.2 at 6 mo (n = 22; P < 0.0001 for all visits). Subjects experienced significant improvement for all visits in average pain (P < .0001), pain interference (P < .0001), and quality of life (P < .003). Four AEs were reported, of which 2 resulted in hospitalization for pneumonia and respiratory failure. All 30 deaths reported during the study were attributed to the underlying malignancy and not related to the study procedure.
Results from this study show rapid (within 3 d) and statistically significant pain improvement with sustained long-term relief through 6 mo in patients treated with RF ablation for metastatic bone disease.
评估射频 (RF) 消融治疗骨转移疼痛的疗效,以最差疼痛评分从基线到 RF 消融后 3 个月的变化来衡量。
100 例(平均年龄 64.6 岁)患者因转移性骨病接受 RF 消融治疗,并随访 6 个月。患者在 RF 消融治疗前和治疗后使用简明疼痛指数和欧洲生活质量问卷评估疼痛和生活质量。收集阿片类药物使用情况以及与设备、程序和/或治疗相关的不良事件(AE)。
87 例患者因胸腰椎肿瘤接受治疗,13 例患者因骨盆和/或骶骨肿瘤接受治疗。所有消融术均获得技术成功,97%的患者随后进行了骨水泥成形术。平均最差疼痛评分从基线时的 8.2±1.7 降至 6 个月时的 3.5±3.2(n=22;所有随访时均 P<0.0001)。所有随访时,患者的平均疼痛(P<0.0001)、疼痛干扰(P<0.0001)和生活质量(P<0.003)均有显著改善。报告了 4 例 AE,其中 2 例因肺炎和呼吸衰竭住院。研究期间报告的所有 30 例死亡均归因于基础恶性肿瘤,与研究程序无关。
本研究结果表明,对于接受 RF 消融治疗的转移性骨病患者,疼痛在 3 天内迅速(3 天内)改善,且在 6 个月内具有统计学显著的长期缓解效果。