P0073 Image-guided percutaneous argon–helium cryoablation for painful bone tumours

Abstract

<h3>Background</h3> We sought to investigate the analgesic effect of cryosurgery on bone-tumour-induced pain. <h3>Methods</h3> Thirty-four patients with bone malignancy were given percutaneous cryosurgery 43 times. Bone biopsies and PET-CT were performed to observe metabolic activity after cryosurgery. NRS scores were recorded and analysed to evaluate the pain-killing effect of cryosurgery. <h3>Findings</h3> After cryosurgery most of the metastatic foci (10 of 13) showed necrosis. Seven of nine showed significant inhibition of metabolism and two showed partial inhibition. 3days after cryosurgery, NRS scores indicated a complete response of pain in 18 patients (53%), partial response in 10 patients (29%), stable disease in four patients (12%), and progressive disease in two patients (6%). At 10days after cryosurgery, complete response of pain was seen in 25 patients (74%), partial response in six patients (18%), stable disease in two patients (6%), and progressive disease in one patient (3%). Twenty (59%) major complications were observed, including 12 cases of local subcutaneous dropsy, one case of skin necrosis over a local small area, and seven cases of fever; no fracture occurred during the hospitalisations. Six patients died at 34, 58, 69, 88, 105days, and 16months, respectively, after cryosurgery. Among them, two patients died of dyscrasia failure, one died of airway obstruction and lung infection, one died of encephalic metastasis, and two died of liver and renal failure. No cause of death was directly related to cryosurgery. The remission time of pain of other patients was 46–232days, median time was 128days. Nine patients' tumours (27%) were recurrent or had a progressive destruction of bone. <h3>Interpretation</h3> Cryosurgery can be accepted as a relatively safe and effective procedure for the palliative treatment of bone tumours, especially for stopping pain.