Palliative osteoplasty provides immediate relief from painful bone metastases

Mar 10, 2009

NEW YORK (Reuters Health), Mar 11 - Percutaneous osteoplasty provides immediate and substantial pain relief in patients with extraspinal lytic lesions due to benign and metastatic diseases who do not respond to conventional analgesic treatment, according to research reported at the Society of Interventional Radiology's annual scientific meeting under way in San Diego.

"The immediate good clinical results observed in our patients should encourage more widespread application of this palliative interventional radiology treatment," Dr. Giovanni C. Anselmetti, from the Institute for Cancer Research and Treatment in Turin, Italy, noted in a written statement from the meeting.

"Metastatic bone disease patients -- who have no other options, who are in pain, who have short life expectancies and who have dismal quality of life -- should be referred ... for osteoplasty treatment," he added.

In the study, researchers assessed the safety and effectiveness of percutaneous injection of semi-liquid bone cement -- in this case, polymethyl-methacrylate -- into bone lesions under combined CT-fluoroscopy guidance and local anesthesia, in 81 consecutive patients (111 lesions).

Seventy-four patients were affected by malignancies (71 by lytic metastases and three by myeloma) and seven by benign diseases (two by geodes in rheumatoid arthritis, one enchondroma, two periprosthetic bone resorption/fracture, one bone cyst, and one trauma). Pelvic, femur, sacrum, ribs, humerus, scapula, tibia, pubis, and knee bones were treated.

No deaths or major complications occurred during the osteoplasty procedures, the researchers report, and within 24 hours of treatment, the mean score on an 11-point visual analogue scale dropped significantly from 8.8 to 1.8.

Sixty-four out of 81 patients (79%) stopped taking narcotic drugs for pain. In 43 patients (53%), analgesic therapy was suspended, and in five patients (6.1%), pain was not improved.

"The clinical outcome we can offer these patients," Dr. Anselmetti told the conference, "is immediate pain relief, long-term pain relief (we have average follow up out to 11 months), and also reduced analgesic use, and very few complications."

By Megan Rauscher

Last Updated: 2009-03-10 16:22:53 -0400 (Reuters Health)

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