Radiofrequency ablation (RFA) for palliative treatment of painful non-small cell lung cancer (NSCLC) rib metastasis: Experience in 12 patients

BACKGROUND Painful rib metastasis is common in non-small cell lung cancer (NSCLC). Pain is often partially or totally refractory to analgesic medications or the side effects of medication are unacceptable. We report the safety and efficacy of a new method: radiofrequency ablation (RFA) in treating painful NSCLC rib metastasis. METHODS RFA procedures were completed in 12 patients with painful rib metastasis. Patient age ranged from 66-83 years (mean 74.8 years, standard deviation (SD) = 5.3). There were four cases of squamous-carcinoma, seven adenocarcinomas, and one case of large cell carcinoma. Pain caused by neoplasm size, pain levels pre-procedure and post-procedure (as assessed using the visual analog scale, VAS), time length, and target temperature of RFA treatments were documented. RESULTS RFA procedures were performed with 100% technical success. The mean pre-procedure and post-procedure pain, as measured by the VAS, was 7.9 (SD = 0.90) and 3.4 (SD = 0.99), respectively. No symptomatic complications occurred. Non-symptomatic complications included one case of pneumothorax and one case of hemoptysis. CONCLUSION RFA appears to be a safe, practical, and effective method for the palliative treatment of painful NSCLC chest wall metastasis.