scholarly journals Impact of radiofrequency ablation (RFA) on bone quality in a murine model of bone metastases

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256076
Author(s):  
Soroush Ghomashchi ◽  
Cari M. Whyne ◽  
Tricia Chinnery ◽  
Fayez Habach ◽  
Margarete K. Akens
Keyword(s):  
Radiofrequency Ablation ◽  
Bone Metastases ◽  
Tumor Cells ◽  
Bone Quality ◽  
Second Harmonic ◽  
Local Treatment ◽  
Skeletal Metastases ◽  
The Impact ◽  
Surrounding Bone

Thermal therapies such as radiofrequency ablation (RFA) are gaining widespread clinical adoption in the local treatment of skeletal metastases. RFA has been shown to successfully destroy tumor cells, yet the impact of RFA on the quality of the surrounding bone has not been well characterized. RFA treatment was performed on femora of rats with bone metastases (osteolytic and osteoblastic) and healthy age matched rats. Histopathology, second harmonic generation imaging and backscatter electron imaging were used to characterize changes in the structure, organic and mineral components of the bone after RFA. RFA treatment was shown to be effective in targeting tumor cells and promoting subsequent new bone formation without impacting the surrounding bone negatively. Mineralization profiles of metastatic models were significantly improved post-RFA treatment with respect to mineral content and homogeneity, suggesting a positive impact of RFA treatment on the quality of cancer involved bone. Evaluating the impact of RFA on bone quality is important in directing the growth of this minimally invasive therapeutic approach with respect to fracture risk assessment, patient selection, and multimodal treatment planning.

scholarly journals INFLUENCE OF PROBIOTIC PRODUCTS ON THE QUALITY OF WASTE WATER TREATMENT IN DAIRY INDUSTRIES

2020 ◽  
Vol 10 (1) ◽  
pp. 47-55
Author(s):  
Elena I. VIALKOVA ◽  
Olga V. SIDORENKO ◽  
Ekaterina S. GLUSHENKO
Keyword(s):  
Anionic Surfactants ◽  
Waste Water Treatment ◽  
Local Treatment ◽  
Dairy Industry ◽  
Treatment Plant ◽  
Oxygen Demand ◽  
Industrial Wastewaters ◽  
High Concentrations ◽  
The Impact

Nowadays there is the problem of the effective treatment of dairy industry plants’ wastewaters. Industrial wastewaters of these plants have high concentrations of organic matters and differ significantly from domestic wastewaters. The method of intensification of dairy wastewaters treatment in Tyumen region, using probiotic «PIP Plus WATER» (Belgium) is considered in this article. The article presents the results of conducted research on the impact of the probiotic on such wastewaters indices as pH, chemical oxygen demand, anionic surfactants, ammonium, nitrites, nitrates and phosphates concentrations. The comparison among different ways of wastewater treatment with probiotics has been made. Based on obtained results technological scheme of local treatment plant of dairy industry plant has been suggested.

scholarly journals Bone metastases: an overview

2017 ◽  
Author(s):  
Filipa Macedo ◽  
Katia Ladeira ◽  
Filipa Pinho ◽  
Nadine Saraiva ◽  
Nuno Bonito ◽  
...  
Keyword(s):  
Bone Metastasis ◽  
Bone Metastases ◽  
Multidisciplinary Approach ◽  
Skeletal Metastases ◽  
Clinical Approach ◽  
Short Term ◽  
Frequent Site ◽  
Primary Bone ◽  
Breast And Prostate Cancer

Bone is a frequent site of metastases and typically indicates a short-term prognosis in cancer patients. Once cancer has spread to the bones it can rarely be cured, but often it can still be treated to slow its growth. The majority of skeletal metastases are due to breast and prostate cancer. Bone metastasis is actually much more common than primary bone cancers, especially in adults. The diagnosis is based on signs, symptoms and imaging. New classes of drugs and new interventions are given a better quality of life to these patients and improved the expectancy of life. It is necessary a multidisciplinary approach to treat patients with bone metastasis. In this paper we review the types, clinical approach and treatment of bone metastases.

The impact of demographics and Medicare payments on quality of external beam radiotherapy for bone metastases in U.S. hospitals.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18504-e18504
Author(s):  
Nikol Mladkova ◽  
Kavita Vyas Dharmarajan
Keyword(s):  
Bone Metastases ◽  
External Beam Radiotherapy ◽  
Linear Regression Analysis ◽  
Office Visit ◽  
Black Population ◽  
Dose Fractionation ◽  
External Beam ◽  
Quality Reporting ◽  
The Impact

e18504 Background: External Beam Radiotherapy (EBRT) has a well-established role in palliation of metastatic bone disease, yet the adherence to evidence based palliative EBRT doses and fractionation schemes is not universal across United States outpatient treatment facilities. We aimed to explore potential disparities in palliative EBRT quality in relation to Medicare visit payments and population demographics. Methods: Centers for Medicare & Medicaid Services (CMS) EBRT for Bone Metastases process measure score for 2018 included in the Hospital Outpatient Quality Reporting Program (Hospital OQR) was available for a total of 824 facilities across the US. The score represents the percentage of evaluated patients that received an acceptable palliative dose/fractionation regimen. Radiation Oncology Office Visit Costs per zip code for new and established patients were obtained from CMS. Demographics (percentage of total population representing males, females, 5 years or younger, under 18 years, 65 or older, white, black or African American, Latino) were obtained from US census. Linear regression analysis was carried out with score representing the dependent variable. Results: The median score was 95% (range 5-100%), average 88.86%. In the final multivariate model, the score was significantly positively associated with the percentage of white population (p = 0.04) and negatively associated with the percentage of population under 18 (p = 0.03), and there was a trend toward association with the mode of Medicare pricing for a new patient visit (p = 0.06). Of note, the percentage of population under 18 was positively correlated with percentage of Latino population (p = 3.155e-09) but not black population (p = 0.9.) There was no association with gender, or with the percentage of those patients who were very young (under 5) or over the age of 65 years. Conclusions: The quality of palliative EBRT in US outpatient facilities is associated with demographic diversity of a given area, with predominantly nondiverse neighborhoods generally receiving higher quality EBRT-based palliative care. Additionally, it appears to be negatively affected by Medicare payments. This data suggests that disparities in healthcare quality are directly mediated by race and partially by geography.

Economic value of zoledronic acid versus placebo in the treatment of skeletal metastases in patients with lung cancer: The case of the United Kingdom (UK)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6617-6617 ◽  
Author(s):  
M. F. Botteman ◽  
I. Foley ◽  
A. A. Marfatia ◽  
J. Brandman ◽  
C. J. Langer
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Zoledronic Acid ◽  
Bone Metastases ◽  
Cancer Patients ◽  
Lung Cancer Patients ◽  
Life Years ◽  
Wide Range ◽  
The Impact

6617 Objectives: Zoledronic acid (ZA) reduces the risk of skeletal-related events (SREs) in lung cancer patients with bone metastases and may improve survival among those patients with high levels of bone metabolism. This analysis assessed, from the UK National Health Service's perspective, the economic impact of ZA therapy in patients with bone metastases secondary to lung cancer. Methods: A literature-based decision analytic model was developed to compare the direct costs and quality adjusted life years (QALY) experienced by lung cancer patients with bone metastases receiving placebo or ZA. Survival, SRE incidence, and number of infusions administered were obtained from a randomized clinical trial comparing 4 mg ZA with placebo. Drug acquisition and administration costs and SRE costs were estimated using published sources and national fee schedules (i.e., NHS reference costs, British National Formulary, Personal Social Services Research Unit reference costs). The impact of SREs on quality of life was estimated using the literature. Consistent with previous economic analyses of bisphosphonates in cancers (e.g., Hillner et al, 2000), patients avoiding SREs were assumed to experience quality of life improvements for 1 month. Results: The average remaining life expectancy was conservatively assumed equal in both groups and was 8.50 months (median, 5.89 months). During those months, patients receiving placebo were projected to experience 2.07 SREs on average compared to 1.32 SREs among ZA patients. QALYs were estimated at 0.3523 per patient (pp) and 0.3350 pp in the ZA and placebo groups, respectively. ZA drug-related costs were estimated at £1,473 pp, based on 5.87 infusions pp and a cost of £251.01 per infusion. The use of ZA was associated with a reduction of £1,562 pp in SRE costs. Overall, ZA saved costs and increased QALYs compared to no therapy, by £89 pp and 0.0173 QALYs pp, respectively. In sensitivity analyses, ZA cost £25,000 or less per QALY under a wide range of assumptions. Conclusions: The use of ZA leads to fewer SREs, better estimated quality of life, and lower costs relative to placebo in UK lung cancer patients with bone metastases. The use of ZA in this population therefore appears highly cost effective. No significant financial relationships to disclose.

The anatomic localization of circulating tumor cells and the immediate impact of surgery and radiofrequency ablation

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e22004-e22004
Author(s):  
L. Jiao ◽  
C. Apostolopoulos ◽  
J. Jacob ◽  
N. Johnson ◽  
N. Tsim ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Liver Metastases ◽  
Tumor Cells ◽  
Circulating Tumor Cells ◽  
Open Surgery ◽  
Colorectal Liver Metastases ◽  
Surgical Interventions ◽  
Resection Of Metastases ◽  
Few Data ◽  
The Impact

e22004 Background: There are few data on the impact of immediate and differing surgical interventions on circulating tumor cells (CTCs), nor their compartmentalization or localization in different anatomic vascular sites. Methods: CTCs from consecutive patients with colorectal liver metastases were quantitated prior to and immediately after open surgery, laparoscopic resection, open radiofrequency ablation (RFA) or percutaneous RFA. For individuals undergoing open surgery, either hepatic resections or open RFA, CTCs were examined in both systemic and portal circulation by measuring CTCs in samples derived from the peripheral vein, an artery, the portal vein and hepatic vein. Results: A total of 29 consecutive patients with colorectal liver metastases were included with a median age of 55 (range 30 - 88 years). CTCs were localized to the hepatic portosystemic macrocirculation with significantly greater numbers than in the systemic vasculature. Surgical procedures led to a statistically significant fall in CTCs at all sites measured (p<0.05). Conversely, RFA, either open or percutaneous was associated with an increase in CTCs. Conclusions: Surgical resection of metastases but not RFA decreases CTC levels. In patients with colorectal liver metastases, CTCs are localized to the hepatic (and probably pulmonary) macrocirculations. This may explain why metastases in sites other than the liver and lungs, are infrequently observed in cancer. No significant financial relationships to disclose.

Economic value of zoledronic acid compared with placebo in the treatment of skeletal metastases in patients with solid tumors: The case of the United Kingdom (UK)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6603-6603
Author(s):  
A. A. Marfatia ◽  
M. F. Botteman ◽  
I. Foley ◽  
J. Brandman ◽  
C. J. Langer
Keyword(s):  
Quality Of Life ◽  
Zoledronic Acid ◽  
Bone Metastases ◽  
Solid Tumors ◽  
Small Cell ◽  
Small Cell Lung ◽  
Life Years ◽  
Wide Range ◽  
The Impact

6603 Background: Zoledronic acid (ZA) reduces the risk of skeletal-related events (SREs) in patients with solid tumors (i.e., renal cell carcinoma, thyroid, head and neck, small cell lung, or others cancers, excluding breast, prostate and non small cell lung [NSCLC] cancers) and bone metastases. This analysis assessed, from the perspective of the UK National Health Service, the economic impact of ZA in this patient population. Methods: A literature-based decision-analytic model was developed to compare the direct costs and quality adjusted life years (QALY) of patients with bone metastases secondary to solid tumors receiving ZA or placebo. Survival, SRE incidence, and number of infusions administered were obtained from a clinical trial comparing patients randomized to 4 mg ZA or placebo for up to 21 months. Drug acquisition and administration costs and SRE costs were estimated using published sources and national fee schedules (e.g., NHS reference costs, British National Formulary). The impact of SREs on quality of life was estimated using the literature. Consistent with previous economic analyses of bisphosphonates in cancers (e.g., Hillner et al, 2000), patients were assumed to experience quality of life improvements lasting 1 month for each SRE avoided. Results: The average remaining life expectancy was conservatively assumed equal in both groups and was 9.54 months (median, 6.61 months). Patients receiving placebo were projected to experience 2.64 SREs on average v. 1.64 SREs among ZA patients. QALYs were estimated at 0.3917 per patient (pp) and 0.3728 pp in the ZA and placebo groups, respectively. ZA drug- related costs were estimated at £1,386 pp, based on an average of 5.52 infusions pp. The use of ZA was associated with a reduction of £1,830 pp in SRE costs. Overall, ZA saved costs and increased QALYs v. no therapy, by £445 pp and 0.0189 QALYs pp, respectively. In sensitivity analyses, ZA cost £25,000 or less per QALY under a wide range of assumptions. Conclusions: The use of ZA leads to fewer SREs, better estimated quality of life, and lower costs relative to placebo in UK patients with bone metastases secondary to solid tumors other than breast, prostate or NSCLC cancer. ZA appears therefore highly cost effective in this population. No significant financial relationships to disclose.

Therapy with Bone-Seeking Radiopharmaceuticals in Patients with Skeletal Metastases Beyond Simple Palliation of Bone Pain

2011 ◽  
Vol 02 (03) ◽  
pp. 142-143
Author(s):  
Giuliano Mariani
Keyword(s):  
Prostate Cancer ◽  
Bone Metastases ◽  
Bone Pain ◽  
Therapeutic Potential ◽  
Multicenter Trial ◽  
Skeletal Metastases ◽  
Metastatic Bone Pain ◽  
One Step ◽  
Hormone Refractory

SummaryBone metastases account for most of the morbidity and deterioration in the quality of life experienced by patients with various types of solid cancers, and occur in about 65–70% of the cases with advanced breast or prostate cancer. Clinical management of metastatic bone pain includes several options (1, 2) to be employed either alone or in varying combinations. One step further in this direction is a multicenter trial exploring the anti-tumour therapeutic potential of the association between 153Sm-EDTMP (Quadramet®) and Docetaxel in patients with hormone-refractory prostate cancer with predominant bone metastases.

Radiofrequency ablation for palliative treatment of osseous metastases results in rapid, significant, and durable improvements in pain relief and quality of life: Results from the OPuS One trial.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12086-12086
Author(s):  
Jason Levy ◽  
Elizabeth David ◽  
Thomas Hopkins ◽  
Jonathan Morris ◽  
Nam D. Tran ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Radiofrequency Ablation ◽  
Pain Relief ◽  
Bone Metastases ◽  
Pain Score ◽  
Palliative Treatment ◽  
Vertebral Augmentation ◽  
Painful Bone Metastases ◽  
Treated Site

12086 Background: Patients with bone metastases may experience pain and decreased quality of life. Standard of care therapies such as radiation therapy could take weeks for pain relief and carry a risk of radiation induced fracture. Minimally invasive percutaneous radiofrequency ablation (RFA) have been shown in small observational studies to be an alternative treatment for bone metastases. We report the results of the OPuS One trial evaluating RFA for the palliative treatment of patients with painful bone metastases. Methods: OPuS One (NCT03249584) was a multicenter prospective trial. 218 subjects with painful bone metastases (≥ 4/10 worst pain scores, Brief Pain Inventory [BPI], at target treated site) were enrolled from 15 sites. RFA was performed under image guidance at one or two locations. Vertebral augmentation was followed based on physician’s discretion. Subjects’ pain (BPI) and quality of life (EQ-5D) scores were calculated in subjects at three days, one week, and one, three, six, and 12 months post RFA. Rate of complete (0 pain score at treated site with no concomitant analgesic increase) and partial responders (≥ 2 pain score reduction without analgesic increase or analgesic reduction of ≥ 25% from baseline) were calculated. Device-, procedure-, and/or therapy-related adverse events (AEs) were collected. Results: 206 subjects, 113 (55%) female and 93 (45%) males (mean age was 63.7 years) were treated with RFA. Most common primary cancers were breast (23%), lung (23%), and kidney (10%). 184 (89%) subjects were treated for metastatic lesions involving the thoracolumbar spine and 22 (11%) subjects were treated for iliac crest, periacetabulum, sacrum or mixed vertebral and pelvic location. 99% (262/264) of RFA procedures were technically successful and 97% were followed by vertebral augmentation. Subjects reported significant improvement in worst pain from baseline at 7.8 to 5.5, 4.7, 3.6, 3.2, 2.4, and 2.6 at three days, one week and one, three, six, and 12 months post RFA, respectively (p < 0.0001 for all visits). Significant improvements were also seen in average pain (p < 0.0001 for all visits), pain interference (p < 0.0001 for all visits), and quality of life scores (p < 0.0001 for all visits). Overall response rates were 53%, 58%, 61%, 63%, 70%, and 75% at three days, one week, one month, three months, six months, and twelve months post RFA, respectively. Six AEs were reported with three as serious: intra-abdominal fluid collection, pneumonia and respiratory failure. 82 deaths were reported during the study, none were related to the device, therapy, and/or procedure. No skeletal related events were reported. Conclusions: In a large prospective multicenter trial, OPuS One, RFA provided rapid, significant, and durable improvements in pain relief and quality of life up to 12 months. Clinical trial information: NCT03249584.

Radiofrequency ablation changes the quality of life of children with supraventricular tachycardias

2015 ◽  
Vol 100 (8) ◽  
pp. 754-757 ◽  
Author(s):  
Hany Mahmoud Abo-Haded
Keyword(s):  
Quality Of Life ◽  
Radiofrequency Ablation ◽  
Study Groups ◽  
Older Children ◽  
First Line Therapy ◽  
Related Quality ◽  
Health Related ◽  
The Difference ◽  
The Impact

ObjectiveRadiofrequency ablation (RFA) has rapidly become the first-line therapy for children with supraventricular tachycardia (SVT). Recently, more attention has been given to the measurement of health-related quality of life (QoL) in children. The primary aim of this study was to determine if there is a change in the QoL in children with SVT pre and post RFA procedure using the Pediatric Quality of Life Inventory (PedsQL) cardiac inventory. In addition, the study discusses the impact of age, gender and variety of SVT mechanisms on the QoL.Design, setting and patientsAll consecutive children with SVT referred for RFA at Mansoura University Children's Hospital were enrolled in this study. The PedsQL cardiac module questionnaire was given to the children/parents to be filled out before and 1 month following RFA procedure. Evaluated areas were physical, emotional, social, school and psychosocial function. The paired t test was used to test the difference between pre-time and post-time points for the study groups. Demographic and clinical data were collected.ResultsThe study sample consisted of 38 patients who underwent a successful ablation. The mean age of the patients at the time of RFA procedure was 12.4±5.3 years. There was a statistically significant improvement in all measured areas 1 month post successful RFA as compared with pre ablation. Post ablation, the greatest score improvement was in physical functioning. Older children (>12 years) showed the greatest benefit, but gender and type of SVT did not influence outcome.ConclusionsRFA therapy is useful in improving QoL and perceptions in children with recurrent SVT.

Sign in / Sign up

Export Citation Format

Share Document