Evaluation of CT Image Guided Radiofrequency Ablation in the Management of Painful Bone Metastases Originating from NSCLC

Background: Pain palliation in patients with bone metastases is of great importance. The ideal treatment method has to be fast, safe, effective and tolerable for the patient. Objective: Evaluation of efficacy and safety of computed tomography (CT) guided radiofrequency ablation (RFA) as a treatment method of painful bone metastases originating from NSCLC. Materials and methods: A total of thirty two patients with painful bone metastases originating from NSCLC were included in our study (median age 67; range 35-88 years). Lesion diameter was between 2 and 6 cm (mean ± SD: 2.8±2cm). Pain was assessed in all patients with the Brief Pain Inventory (BPI). All patients were treated with RFA under CT guidance, under conscious sedation. RFAs were performed either with RITA Model 1500® electrosurgical generator with a seven-array multitined electrode or AMICA electrosurgical generator, depending on the lesion’s size. Mean ablation time was 9.5 minutes. Technically successful ablation was considered when lesion was completely covered according to protocol. After each session a CT scan was performed in order to exclude complications. Patients were hospitalised up to 24 hours for clinical monitoring. Post-ablation assessment with BPI score and report of the use of analgesics was performed with telephone interview one, four and eight weeks after the ablation. Results: We observed significant decrease in the mean past day BPI score for worst pain, for average pain and for pain interference during daily life in comparison to pre procedural symptoms (P<0.001, paired t-test), one, four and eight weeks after treatment. There was also a marked decrease in the use of analgesics. None complication occurred. Conclusions: RFA appears to be a promising treatment method for painful bone metastases originating from NSCLC as it is a safe, fast, minimal invasive method with high efficacy and security.