Percutaneous Radiofrequency Ablation of Painful Osseous Metastases A Multicenter American College of Radiology Imaging Network Trial

BACKGROUND: The study was conducted to determine whether radiofrequency ablation (RFA) can safely reduce pain from osseous metastatic disease. METHODS: The single-arm prospective trial included patients with a single painful bone metastasis with unremitting pain with a score >50 on a pain scale of 0-100. Percutaneous computed tomography-guided RFA of the bone metastasis to temperatures >60 degrees C was performed. Endpoints were the toxicity and pain effects of RFA before and at 2 weeks, I month, and 3 months after RFA. RESULTS: Fifty-five patients completed RFA. Grade 3 toxicities occurred in 3 of 55 (5%) patients. RFA reduced pain at 1 and 3 months for all pain assessment measures. The average increase in pain relief from pre-RFA to 1-month follow-up is 26.3 (95% confidence interval [CI], 17.7-34.9; P < 0001), and the increase from pre-RFA to 3-month follow-up is 16.38 (95% CI, 3.4-29.4; P=.02). The average decrease in pain intensity from pre-RFA to 1-month follow-up was 26.9 (P<.0001) and 14.2 for 3-month follow-up (P=.02). The odds of lower pain severity at 1-month follow-up were 14.0 (95% CI, 2.3-25.7; P < .0001) times higher than at pre-RFA, and the odds at 3-month follow-up were 8.0 (95% CI, 0.9-15.2; P < .001) times higher than at pre-RFA. The average increase in mood from pre-RFA to 1-month follow-up was 19.9 (P < .0001) and 14.9 to 3-month follow-up (P=.005). CONCLUSIONS: This cooperative group trial strongly suggests that RFA can safely palliate pain from bone metastases. Cancer 2010;116:989-97. (C) 2070 American Cancer Society