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J Vasc Interv Radiol ; 30(12): 1934-1940, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31669085

RESUMO

PURPOSE: To evaluate the efficacy and safety of microwave (MW) ablation combined with percutaneous osteoplasty (POP) on painful extraspinal bone metastases. MATERIALS AND METHODS: In this retrospective study, 50 adult patients with 56 extraspinal bone metastasis lesions, who suffered from refractory moderate to severe pain, were treated with MW ablation and POP. Changes in quality of life were evaluated based on the Visual Analog Scale (VAS), daily morphine consumption, and the Oswestry Disability Index (ODI) before and immediately after the procedure and during follow-up times. RESULTS: Technical success was achieved in all patients. Mean preoperative VAS score and morphine dose were 7.0 ± 2.6 (range, 3-10) and 66.7 ± 33.2 mg (range, 10-120 mg), respectively. Mean postoperative VAS scores and daily morphine doses were as follows: 1 day, 3.5 ± 2.1 and 36.1 ± 25.8 mg (P < .05); 1 week, 1.5 ± 1.7 and 12.2 ± 14.8 mg (P < .001); 1 month, 0.9 ± 1.4 and 5.7 ± 10.0 mg (P < .001); and 3 months, 0.6 ± 1.2 and 4.7 ± 8.4 mg (P < .001). A significant decrease in the ODI score was also observed (P < .05). Periprocedural death was not observed. A pathologic fracture occurred in 1 (2%) patient with femoral metastasis, and local infection was observed in 2 (4%) patients. Minor cement leakage occurred in 4 (8%) patients with no symptomatic or intra-articular extravasation. No local tumor progression occurred in patients with imaging follow-up. CONCLUSIONS: MW ablation combined with POP is an effective and safe treatment for painful extraspinal bone metastases, which can significantly relieve pain and improve quality of life.


Assuntos
Técnicas de Ablação , Neoplasias Ósseas/cirurgia , Cementoplastia , Micro-Ondas/uso terapêutico , Manejo da Dor , Dor/cirurgia , Cuidados Paliativos , Técnicas de Ablação/efeitos adversos , Adulto , Idoso , Analgésicos Opioides/administração & dosagem , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/secundário , Cementoplastia/efeitos adversos , Terapia Combinada , Avaliação da Deficiência , Feminino , Humanos , Masculino , Micro-Ondas/efeitos adversos , Pessoa de Meia-Idade , Morfina/administração & dosagem , Dor/diagnóstico , Manejo da Dor/efeitos adversos , Medição da Dor , Qualidade de Vida , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
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