Minimally Invasive Percutaneous Treatment in the Palliation of Painful Bone Metastases

AbstractThe prevalence of patients with painful bone metastases is constantly increasing. This is related to the rising incidence of cancer and increasing life expectancy of patients with metastatic stage. Advances in imaging and development of percutaneous techniques have gradually allowed offering minimally invasive acts on these metastases: cementing, vertebral augmentation, osteosynthesis, percutaneous thermal ablation, neurolysis, embolization. The purpose of this article is to present the main tools available to date for the interventional radiologist so that each participant can understand their functioning, indications, and limits.

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Treatment of painful bone metastases in prostate and breast cancer patients with the therapeutic radiopharmaceutical rhenium-188-HEDP

Nuklearmedizin ◽

10.3413/nukmed-0828-16-05 ◽

2016 ◽

Vol 55 (05) ◽

pp. 188-195 ◽

Cited By ~ 16

Author(s):

Floor Overbeek ◽

John de Klerk ◽

Pieternel Pasker-de Jong ◽

Alexandra van den Berk ◽

Rob ter Heine ◽

...

Keyword(s):

Bone Metastases ◽

Clinical Benefit ◽

Response Rate ◽

Clinical Care ◽

Pain Response ◽

Pain Palliation ◽

Breast Cancer Patients ◽

Routine Clinical Care ◽

Painful Bone Metastases

Summary Aim: Rhenium-188-HEDP (188Re-HEDP) is an effective radiopharmaceutical for the palliative treatment of osteoblastic bone metastases. However, only limited data on its routine use are available and its effect on quality of life (QoL) has not been studied. Therefore, we evaluated the clinical benefit of 188Re-HEDP in routine clinical care. Patients and methods: Prostate or breast cancer patients with painful bone metastases receiving 188Re-HEDP as a routine clinical procedure were eligible for evaluation. Clinical benefit was assessed in terms of efficacy and toxicity. Pain palliation and QoL were monitored using the visual analogue scale (VAS), corrected for opioid intake, and the EORTC QLQ-C30 Global health status/QoL-scale. Thrombocyte and leukocyte nadirs were used to assess haematological toxicity. Results: 45 and 47 patients were evaluable for pain palliation and QoL, respectively. After a single injection of 188Re-HEDP, the overall pain response rate was 69% and mean VAS-scores decreased relevantly and significantly (p < 0.05). Repeated treatment resulted in similar pain response. The overall QoL response rate was 68% and mean Global health status/QoL-scores increased relevantly and significantly. Haematological side effects were mild and transient. Conclusion: The clinically relevant response on pain and quality of life and the limited adverse events prove clinical benefit of treatment with 188Re-HEDP and support its use in routine clinical care. Its effectiveness appears comparable to that of external beam radiotherapy.

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Minimally Invasive Local Treatments for Bone and Pulmonary Metastases

Minimally Invasive Surgery ◽

10.1155/2014/719394 ◽

2014 ◽

Vol 2014 ◽

pp. 1-9 ◽

Cited By ~ 3

Author(s):

Meena Bedi ◽

David M. King ◽

Sean Tutton

Keyword(s):

Minimally Invasive ◽

Bone Metastases ◽

Metastatic Disease ◽

Pulmonary Metastases ◽

Alternative Therapies ◽

Minimally Invasive Techniques ◽

Invasive Techniques

Surgery and chemotherapy have historically been the mainstay of treatment in patients with metastatic disease. However there are many alternative therapies available to relieve the symptoms and morbidity of metastases. In this paper, we review the role and highlight the advantages of minimally invasive techniques employed in patients with pulmonary and bone metastases.

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