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Erschienen in: CardioVascular and Interventional Radiology 3/2014

01.06.2014 | Clinical Investigation

Management of Painful Pelvic Bone Metastasis of Renal Cell Carcinoma Using Embolization, Radio-frequency Ablation, and Cementoplasty: A Prospective Evaluation of Efficacy and Safety

verfasst von: Olivier Pellerin, Jacques Medioni, Claire Vulser, Carole Déan, Stéphane Oudard, Marc Sapoval

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 3/2014

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Abstract

Purpose

To measure the impact on pain relief and patient quality of life using embolization radio-frequency ablation and cementoplasty (ERC) for local combination therapeutic management of painful pelvic bone metastasis of renal cell carcinoma (RCC).

Materials and Methods

This prospective monocentric registry was approved by our Local Institutional Review Board. Between January 2008 and January 2013, all consecutive patients who fully met the inclusion criteria were enrolled in the ERC-procedure prospective registry. They were assigned to follow-up at discharge and again at 1 and 6 months. Efficacy was evaluated using a pain visual analog scale (VAS), and narcotic consumption and quality of life were assessed using the Brief Pain Inventory questionnaire.

Results

Fifty-two patients were enrolled, among whom 58 lesions were treated. Technical success was obtained in all procedures. The median VAS score decreased from 7 ± 1.4 (ranges 5–10) at baseline to 3 ± 1.5 (ranges 0–6) at discharge, 2 ± 1.5 (ranges 0–5) at 1 month (p < 0.0001), and 2 ± 1.6 (ranges 0–5) at 6 months. In 28 patients (54 %), narcotic consumption was halved at discharge and halved in 40 (77 %) patients at 1 and 6 months compared with baseline. Five patients had complete pain relief at 1 month. A major improvement in quality of life, especially regarding mood and motion, was observed in all patients.

Conclusion

This specific approach to painful bone metastasis is efficient and safe and yields sustained results. The ERC procedure could be suggested for patients with RCC bone metastasis.
Literatur
1.
Zurück zum Zitat Badalian G, Derecskei K, Szendroi A, Szendroi M, Timar J (2007) EGFR and VEGFR2 protein expressions in bone metastases of clear cell renal cancer. Anticancer Res 27(2):889–894PubMed Badalian G, Derecskei K, Szendroi A, Szendroi M, Timar J (2007) EGFR and VEGFR2 protein expressions in bone metastases of clear cell renal cancer. Anticancer Res 27(2):889–894PubMed
2.
Zurück zum Zitat Beuselinck B, Oudard S, Rixe O et al (2011) Negative impact of bone metastasis on outcome in clear-cell renal cell carcinoma treated with sunitinib. Ann Oncol 22(4):794–800PubMedCrossRef Beuselinck B, Oudard S, Rixe O et al (2011) Negative impact of bone metastasis on outcome in clear-cell renal cell carcinoma treated with sunitinib. Ann Oncol 22(4):794–800PubMedCrossRef
3.
Zurück zum Zitat Boureau F, Luu M, Doubrere JF, Gay C (1984) Construction of a questionnaire for the self-evaluation of pain using a list of qualifiers. Comparison with Melzack’s McGill Pain Questionnaire. Therapie 39(2):119–129PubMed Boureau F, Luu M, Doubrere JF, Gay C (1984) Construction of a questionnaire for the self-evaluation of pain using a list of qualifiers. Comparison with Melzack’s McGill Pain Questionnaire. Therapie 39(2):119–129PubMed
4.
Zurück zum Zitat Callstrom MR, Atwell TD, Charboneau JW et al (2006) Painful metastases involving bone: percutaneous image-guided cryoablation—Prospective trial interim analysis. Radiology 241(2):572–580PubMedCrossRef Callstrom MR, Atwell TD, Charboneau JW et al (2006) Painful metastases involving bone: percutaneous image-guided cryoablation—Prospective trial interim analysis. Radiology 241(2):572–580PubMedCrossRef
5.
Zurück zum Zitat Callstrom MR, Dupuy DE, Solomon SB et al (2013) Percutaneous image-guided cryoablation of painful metastases involving bone: multicenter trial. Cancer 119(5):1033–1041PubMedCrossRef Callstrom MR, Dupuy DE, Solomon SB et al (2013) Percutaneous image-guided cryoablation of painful metastases involving bone: multicenter trial. Cancer 119(5):1033–1041PubMedCrossRef
6.
Zurück zum Zitat Callstrom MR, York JD, Gaba RC et al (2009) Research reporting standards for image-guided ablation of bone and soft tissue tumors. J Vasc Interv Radiol 20(12):1527–1540PubMedCrossRef Callstrom MR, York JD, Gaba RC et al (2009) Research reporting standards for image-guided ablation of bone and soft tissue tumors. J Vasc Interv Radiol 20(12):1527–1540PubMedCrossRef
7.
Zurück zum Zitat Carrafiello G, Dionigi G, Boni L et al (2011) Current role of interventions in metastatic kidney tumors: single center experience. Updates Surg 63(4):259–269PubMedCrossRef Carrafiello G, Dionigi G, Boni L et al (2011) Current role of interventions in metastatic kidney tumors: single center experience. Updates Surg 63(4):259–269PubMedCrossRef
8.
Zurück zum Zitat Carrafiello G, Lagana D, Pellegrino C et al (2009) Percutaneous imaging-guided ablation therapies in the treatment of symptomatic bone metastases: preliminary experience. Radiol Med 114(4):608–625PubMedCrossRef Carrafiello G, Lagana D, Pellegrino C et al (2009) Percutaneous imaging-guided ablation therapies in the treatment of symptomatic bone metastases: preliminary experience. Radiol Med 114(4):608–625PubMedCrossRef
9.
Zurück zum Zitat Chatziioannou AN, Johnson ME, Pneumaticos SG, Lawrence DD, Carrasco CH (2000) Preoperative embolization of bone metastases from renal cell carcinoma. Eur Radiol 10(4):593–596PubMedCrossRef Chatziioannou AN, Johnson ME, Pneumaticos SG, Lawrence DD, Carrasco CH (2000) Preoperative embolization of bone metastases from renal cell carcinoma. Eur Radiol 10(4):593–596PubMedCrossRef
10.
Zurück zum Zitat Chiras J, Adem C, Vallee JN, Spelle L, Cormier E, Rose M (2004) Selective intra-arterial chemoembolization of pelvic and spine bone metastases. Eur Radiol 14(10):1774–1780PubMedCrossRef Chiras J, Adem C, Vallee JN, Spelle L, Cormier E, Rose M (2004) Selective intra-arterial chemoembolization of pelvic and spine bone metastases. Eur Radiol 14(10):1774–1780PubMedCrossRef
11.
Zurück zum Zitat Courtheoux P, Alachkar F, Casasco A et al (1985) Chemoembolization of lumbar spine metastases A preliminary study. J Neuroradiol 12(2):151–162PubMed Courtheoux P, Alachkar F, Casasco A et al (1985) Chemoembolization of lumbar spine metastases A preliminary study. J Neuroradiol 12(2):151–162PubMed
12.
Zurück zum Zitat Emmanouilides C, Chourmouzi D, Dedes I, Pantoleon D, Mantziari P, Drevelengas A (2009) Successful management of bulky osseous metastasis of renal cell carcinoma with selective arterial embolization and radiofrequency ablation: a case report. Cases J 2:6484PubMedCentralPubMedCrossRef Emmanouilides C, Chourmouzi D, Dedes I, Pantoleon D, Mantziari P, Drevelengas A (2009) Successful management of bulky osseous metastasis of renal cell carcinoma with selective arterial embolization and radiofrequency ablation: a case report. Cases J 2:6484PubMedCentralPubMedCrossRef
13.
Zurück zum Zitat Forauer AR, Kent E, Cwikiel W, Esper P, Redman B (2007) Selective palliative transcatheter embolization of bony metastases from renal cell carcinoma. Acta Oncol 46(7):1012–1018PubMedCrossRef Forauer AR, Kent E, Cwikiel W, Esper P, Redman B (2007) Selective palliative transcatheter embolization of bony metastases from renal cell carcinoma. Acta Oncol 46(7):1012–1018PubMedCrossRef
14.
15.
Zurück zum Zitat Haynes SR, Lawler PG (1995) An assessment of the consistency of ASA physical status classification allocation. Anaesthesia 50(3):195–199PubMedCrossRef Haynes SR, Lawler PG (1995) An assessment of the consistency of ASA physical status classification allocation. Anaesthesia 50(3):195–199PubMedCrossRef
16.
Zurück zum Zitat Heran MK, Legiehn GM, Munk PL (2006) Current concepts and techniques in percutaneous vertebroplasty. Orthop Clin North Am 37(3):409–434 viiPubMedCrossRef Heran MK, Legiehn GM, Munk PL (2006) Current concepts and techniques in percutaneous vertebroplasty. Orthop Clin North Am 37(3):409–434 viiPubMedCrossRef
17.
Zurück zum Zitat Ishiyama H, Shibata A, Niino K, Hosoya T (2004) Relationship between morphine and radiotherapy for management of symptomatic bone metastases from lung cancer. Support Care Cancer 12(10):743–745PubMedCrossRef Ishiyama H, Shibata A, Niino K, Hosoya T (2004) Relationship between morphine and radiotherapy for management of symptomatic bone metastases from lung cancer. Support Care Cancer 12(10):743–745PubMedCrossRef
18.
Zurück zum Zitat Kato T, Nemoto R, Mori H, Takahashi M, Harada M (1981) Arterial chemoembolization with mitomycin C microcapsules in the treatment of primary or secondary carcinoma of the kidney, liver, bone and intrapelvic organs. Cancer 48(3):674–680PubMedCrossRef Kato T, Nemoto R, Mori H, Takahashi M, Harada M (1981) Arterial chemoembolization with mitomycin C microcapsules in the treatment of primary or secondary carcinoma of the kidney, liver, bone and intrapelvic organs. Cancer 48(3):674–680PubMedCrossRef
19.
Zurück zum Zitat Kickuth R, Waldherr C, Hoppe H et al (2008) Interventional management of hypervascular osseous metastasis: role of embolotherapy before orthopedic tumor resection and bone stabilization. AJR Am J Roentgenol 191(6):W240–W247PubMedCrossRef Kickuth R, Waldherr C, Hoppe H et al (2008) Interventional management of hypervascular osseous metastasis: role of embolotherapy before orthopedic tumor resection and bone stabilization. AJR Am J Roentgenol 191(6):W240–W247PubMedCrossRef
20.
Zurück zum Zitat Lane MD, Le HB, Lee S et al (2011) Combination radiofrequency ablation and cementoplasty for palliative treatment of painful neoplastic bone metastasis: experience with 53 treated lesions in 36 patients. Skeletal Radiol 40(1):25–32PubMedCrossRef Lane MD, Le HB, Lee S et al (2011) Combination radiofrequency ablation and cementoplasty for palliative treatment of painful neoplastic bone metastasis: experience with 53 treated lesions in 36 patients. Skeletal Radiol 40(1):25–32PubMedCrossRef
21.
Zurück zum Zitat Mikami S, Katsube K, Oya M et al (2009) Increased RANKL expression is related to tumour migration and metastasis of renal cell carcinomas. J Pathol 218(4):530–539PubMedCrossRef Mikami S, Katsube K, Oya M et al (2009) Increased RANKL expression is related to tumour migration and metastasis of renal cell carcinomas. J Pathol 218(4):530–539PubMedCrossRef
22.
Zurück zum Zitat Motzer RJ, Hutson TE, Tomczak P et al (2009) Overall survival and updated results for sunitinib compared with interferon alfa in patients with metastatic renal cell carcinoma. J Clin Oncol 27(22):3584–3590PubMedCentralPubMedCrossRef Motzer RJ, Hutson TE, Tomczak P et al (2009) Overall survival and updated results for sunitinib compared with interferon alfa in patients with metastatic renal cell carcinoma. J Clin Oncol 27(22):3584–3590PubMedCentralPubMedCrossRef
23.
Zurück zum Zitat Nakatsuka A, Yamakado K, Maeda M et al (2004) Radiofrequency ablation combined with bone cement injection for the treatment of bone malignancies. J Vasc Interv Radiol 15(7):707–712PubMedCrossRef Nakatsuka A, Yamakado K, Maeda M et al (2004) Radiofrequency ablation combined with bone cement injection for the treatment of bone malignancies. J Vasc Interv Radiol 15(7):707–712PubMedCrossRef
24.
Zurück zum Zitat Oken MM, Creech RH, Tormey DC et al (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5(6):649–655PubMedCrossRef Oken MM, Creech RH, Tormey DC et al (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5(6):649–655PubMedCrossRef
25.
Zurück zum Zitat Pereira J, Lawlor P, Vigano A, Dorgan M, Bruera E (2001) Equianalgesic dose ratios for opioids. A critical review and proposals for long-term dosing. J Pain Symptom Manag 22(2):672–687CrossRef Pereira J, Lawlor P, Vigano A, Dorgan M, Bruera E (2001) Equianalgesic dose ratios for opioids. A critical review and proposals for long-term dosing. J Pain Symptom Manag 22(2):672–687CrossRef
26.
Zurück zum Zitat Pusceddu C, Sotgia B, Fele RM, Melis L (2013) Treatment of bone metastases with microwave thermal ablation. J Vasc Interv Radiol 24(2):229–233PubMedCrossRef Pusceddu C, Sotgia B, Fele RM, Melis L (2013) Treatment of bone metastases with microwave thermal ablation. J Vasc Interv Radiol 24(2):229–233PubMedCrossRef
27.
Zurück zum Zitat Staahl C, Christrup LL, Andersen SD, Arendt-Nielsen L, Drewes AM (2006) A comparative study of oxycodone and morphine in a multimodal, tissue-differentiated experimental pain model. Pain 123(1–2):28–36PubMedCrossRef Staahl C, Christrup LL, Andersen SD, Arendt-Nielsen L, Drewes AM (2006) A comparative study of oxycodone and morphine in a multimodal, tissue-differentiated experimental pain model. Pain 123(1–2):28–36PubMedCrossRef
28.
Zurück zum Zitat Staehler M, Haseke N, Stadler T et al (2010) Feasibility and effects of high-dose hypofractionated radiation therapy and simultaneous multikinase inhibition with sunitinib in progressive metastatic renal cell cancer. Urol Oncol 30(3):290–293PubMedCrossRef Staehler M, Haseke N, Stadler T et al (2010) Feasibility and effects of high-dose hypofractionated radiation therapy and simultaneous multikinase inhibition with sunitinib in progressive metastatic renal cell cancer. Urol Oncol 30(3):290–293PubMedCrossRef
29.
Zurück zum Zitat Sun S, Lang EV (1998) Bone metastases from renal cell carcinoma: preoperative embolization. J Vasc Interv Radiol 9(2):263–269PubMedCrossRef Sun S, Lang EV (1998) Bone metastases from renal cell carcinoma: preoperative embolization. J Vasc Interv Radiol 9(2):263–269PubMedCrossRef
30.
Zurück zum Zitat Thacker PG, Callstrom MR, Curry TB et al (2011) Palliation of painful metastatic disease involving bone with imaging-guided treatment: comparison of patients’ immediate response to radiofrequency ablation and cryoablation. AJR Am J Roentgenol 197(2):510–515PubMedCrossRef Thacker PG, Callstrom MR, Curry TB et al (2011) Palliation of painful metastatic disease involving bone with imaging-guided treatment: comparison of patients’ immediate response to radiofrequency ablation and cryoablation. AJR Am J Roentgenol 197(2):510–515PubMedCrossRef
31.
Zurück zum Zitat Urch C (2004) The pathophysiology of cancer-induced bone pain: current understanding. Palliat Med 18(4):267–274PubMedCrossRef Urch C (2004) The pathophysiology of cancer-induced bone pain: current understanding. Palliat Med 18(4):267–274PubMedCrossRef
32.
Zurück zum Zitat Woodward E, Jagdev S, McParland L et al (2011) Skeletal complications and survival in renal cancer patients with bone metastases. Bone 48(1):160–166PubMedCrossRef Woodward E, Jagdev S, McParland L et al (2011) Skeletal complications and survival in renal cancer patients with bone metastases. Bone 48(1):160–166PubMedCrossRef
33.
Zurück zum Zitat Woolf CJ, Allchorne A, Safieh-Garabedian B, Poole S (1997) Cytokines, nerve growth factor and inflammatory hyperalgesia: the contribution of tumour necrosis factor alpha. Br J Pharmacol 121(3):417–424PubMedCentralPubMedCrossRef Woolf CJ, Allchorne A, Safieh-Garabedian B, Poole S (1997) Cytokines, nerve growth factor and inflammatory hyperalgesia: the contribution of tumour necrosis factor alpha. Br J Pharmacol 121(3):417–424PubMedCentralPubMedCrossRef
34.
Zurück zum Zitat Zekri J, Ahmed N, Coleman RE, Hancock BW (2001) The skeletal metastatic complications of renal cell carcinoma. Int J Oncol 19(2):379–382PubMed Zekri J, Ahmed N, Coleman RE, Hancock BW (2001) The skeletal metastatic complications of renal cell carcinoma. Int J Oncol 19(2):379–382PubMed
Metadaten
Titel
Management of Painful Pelvic Bone Metastasis of Renal Cell Carcinoma Using Embolization, Radio-frequency Ablation, and Cementoplasty: A Prospective Evaluation of Efficacy and Safety
verfasst von
Olivier Pellerin
Jacques Medioni
Claire Vulser
Carole Déan
Stéphane Oudard
Marc Sapoval
Publikationsdatum
01.06.2014
Verlag
Springer US
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 3/2014
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-013-0740-x

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