Effectiveness of Radiofrequency Ablation in the Treatment of Painful Osseous Metastases: A Correlation Meta-Analysis with Machine Learning Cluster Identification.

Journal: Journal of vascular and interventional radiology : JVIR
PMID: 33012648

Abstract

A systematic review and meta-analysis of pain response after radiofrequency (RF) ablation over time for osseous metastases was conducted in 2019. Analysis used a random-effects model with GOSH plots and meta-regression. Fourteen studies comprising 426 patients, most with recalcitrant pain, were identified. Median pain reduction after RF ablation was 67% over median follow-up of 24 weeks (R = -.66, 95% confidence interval -0.76 to -0.55, I = 71.24%, fail-safe N = 875) with 44% pain reduction within 1 week. A low-heterogeneity subgroup was identified with median pain reduction after RF ablation of 70% over 12 weeks (R = -.75, 95% confidence interval -0.80 to -0.70, I = 2.66%, fail-safe N = 910). Addition of cementoplasty after RF ablation did not significantly affect pain scores. Primary tumor type and tumor size did not significantly affect pain scores. A particular, positive association between pain after RF ablation and axial tumors was identified, implying possible increased palliative effects for RF ablation on axial over appendicular lesions. RF ablation is a useful palliative therapy for osseous metastases, particularly in patients with recalcitrant pain.

Authors

  • Tej Ishaan Mehta
    Department of Interventional Radiology, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD 21287. Electronic address: tej.mehta@coyotes.usd.edu.
  • Caleb Heiberger
    Department of Interventional Radiology, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD 21287.
  • Stephanie Kazi
    University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.
  • Mark Brown
    University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.
  • Simcha Weissman
    Hackensack Meridian Health Palisades Medical Center, North Bergen, New Jersey.
  • Kelvin Hong
    Department of Interventional Radiology, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD 21287.
  • Minesh Mehta
    Miami Cancer Institute, Miami, Florida.
  • Douglas Yim
    Avera Medical Group, Sioux Falls, South Dakota.

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