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Erschienen in: CardioVascular and Interventional Radiology 6/2008

01.11.2008 | Clinical Investigation

Treatment of Extraspinal Painful Bone Metastases with Percutaneous Cementoplasty: A Prospective Study of 50 Patients

verfasst von: Giovanni Carlo Anselmetti, Antonio Manca, Cinzia Ortega, Giovanni Grignani, Felicino DeBernardi, Daniele Regge

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 6/2008

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Abstract

The aim of this study was to assess the efficacy of percutaneous cementoplasty (PC) with polymethylmethacrylate (PMMA) in painful extravertebral lytic bone metastases not responding to conventional therapy. Fifty patients (25 females), mean age 64.7 ± 11.2 years, underwent PC after giving informed consent. Procedures were performed under fluoroscopy (1/50) or combined fluoroscopy-CT (49/50) guidance in local anesthesia or under deep sedation in 7 patients with large metastases who underwent radiofrequency thermoablation (RFA) in the same session. Seventy lesions were treated (1-6 per patient; average, 1.4 ± 0.9), arranging in size from 1 to 10 cm (average, 3.6 ± 2.1 cm). Mean volume of PMMA per lesion was 5.9 ± 3.2 ml (range, 1.5–15.0 ml). Pain was prospectively evaluated on an 11-point visual analog scale (VAS) before and after the procedure (follow-up, 15 to 36 months). Mean VAS score dropped from 9.1 ± 1.2 (range: 6–10) to 2.1 ± 2.5 (range: 0–9). Mean VAS difference was 7.0 ± 2.3 (range, 1–10; p < 0.0001, Wilcoxon signed rank test). Forty-seven of the 50 patients (94%) suspended narcotic drugs, in 22 (44%) pain was controlled with a nonsteroidal anti-inflammatory drug, in 25 (50%) analgesic therapy was suspended, and 13 of 50 (26%) had complete pain regression. In 3 of the 50 patients (6%) pain was not improved. No statistical difference between osteoplasty and osteoplasty plus RFA was found (p = 0.8338, Mann–Whitney test). No complications arose during the procedure. Two patients with metastases in the femoral diaphysis reported a fracture 1 month after treatment. PC is effective to obtain pain regression in painful bone metastases not responding to conventional analgesic therapy; bone consolidation cannot be obtained in the diaphysis of long weight-bearing bones.
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Metadaten
Titel
Treatment of Extraspinal Painful Bone Metastases with Percutaneous Cementoplasty: A Prospective Study of 50 Patients
verfasst von
Giovanni Carlo Anselmetti
Antonio Manca
Cinzia Ortega
Giovanni Grignani
Felicino DeBernardi
Daniele Regge
Publikationsdatum
01.11.2008
Verlag
Springer-Verlag
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 6/2008
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-008-9396-3

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