Abstract No. 398 - Initial two experience in interventional palliative oncology

Abstract

Purpose This study is a retrospective analysis of the change in symptomology and complication rates following cryoablation of painful boney or soft tissue lesions. Materials and Methods Thirty-one image-guided percutaneous cryoablation procedures were performed on 26 patients’ with painful boney or soft-tissue lesions. All patients were seen in interventional oncology palliative clinics from 10/2010 to 9/2012. Referrals were generated from surgical oncology, medical oncology, or radiation therapy, to obviate known post radiation sequela, lesions with high reoccurrence rates or patient preference. All procedures were performed under moderate sedation with the exception of 5 procedures (1 patient preference, 3 children and1 real-time neurology monitoring). All patients were assessed in clinic one month following procedure, using four criteria for there painful symptomology: no improvement of symptoms, improvement of symptoms, worsening of symptoms and complications. Concomitant cementoplasty was also performed. Complications were classified by the SIR clinical practice guidelines. Results There were 11 males and 15 females, a mean age of 48 yo (7-79 yo). Etiology for painful boney lesions: 8 RCC, 4 desmoid, 3 osteoid osteoma, 2 sarcoma, 2 HCC, 1 each fibromatosis, multiple myeloma, lung cancer, rectal cancer, bladder cancer, pancreatic cancer, chondrosarcoma and giant cell tumor. Single session treatments were predominantly performed with the exception of 3 patients who underwent schedule-staged follow-up procedure (2 procedures and 1 patient three procedures). An absence or no improvement of symptoms was noted in 2 (8%) patients, worsening of symptoms 2 (8%) and improvement of painful symptoms was noted in 22 (86%). Major complication rate were 8% (2/26) and minor complications were 13% (3/26). Conclusion Interventional radiologists are playing an increasing role in interventional palliative oncology. Our study demonstrates a high rate of improved bone pain palliation accompanying low morbidly rate among a broad spectrum of pathologies.