Analgesic Effects of Microwave Ablation of Bone and Soft Tissue Tumors Under Local Anesthesia

• Published in: Pain medicine (Malden, Mass.) Vol. 14; no. 12; pp. 1873 - 1881
• Main Authors: Kastler, Adrian, Alnassan, Hussein, Pereira, Philippe L., Alemann, Guillaume, Barbé, Daniel‐Ange, Aubry, Sébastien, Tiberghien, Florence, Kastler, Bruno
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.12.2013
• Subjects: Adult; Aged; Aged, 80 and over; Anesthesia, Local; Bone Neoplasms - complications; Bone Neoplasms - radiotherapy; Bone Tumors; Catheter Ablation; CT Guidance; Female; Humans; Local Anesthesia; Male; Microwave Ablation; Microwaves - therapeutic use; Middle Aged; Pain - etiology; Pain - radiotherapy; Pain Management - methods; Pain Measurement; Radiography, Interventional - methods; Retrospective Studies; Soft Tissue Neoplasms - complications; Soft Tissue Neoplasms - radiotherapy; Soft Tissue Tumors; Microwave Ablation; Local Anesthesia; Soft Tissue Tumors; CT Guidance; Bone Tumors
• ISSN: 1526-2375; 1526-4637; 1526-4637
• DOI: 10.1111/pme.12242

Objective To assess the feasibility and efficacy of microwave ablation (MWA) of painful refractory bone and soft tissue tumors performed under local anesthesia. Study Design A retrospective study between 2011 and 2013. Setting A single center, Academic Interventional Pain Management Unit. Subjects Fifteen patients with 25 refractory painful bone (N = 19) or soft tissue (N = 6) tumors treated with MWA were consecutively included. Method Local Institutional Review Board approval was obtained, and written informed consent was waived. Lesions included spinal (N = 3), sacral (N = 4), and extraspinal (N = 18) locations. Pain was measured on a visual analog scale (VAS) from 0 to 10 before and immediately after procedure, at 1 week, and on a monthly basis following procedure. MWA procedures were always performed under computed tomography guidance and local anesthesia along with nitrous oxide inhalation. Results Mean ablation time was 4.09 minutes (range 1–11) with an average of 4.2 cycles with a mean ablation power of 60 W. Preprocedure mean VAS score was 7.2 ± 0.97 (range 6–9). Follow‐up postprocedure VAS scores were as follows: day 0: 1.64 ± 1.86, day 7: 1.82 ± 1.79, month 1: 2.05 ± 2.03 (14/15 patients), month 3: 2.13 ± 1.81, month 6: 2.36 ± 2.17; and were statistically significant (P < 0.001). Mean pain relief was 5.5 months. Conclusion MWA is feasible, safe, and effective in the management of painful refractory bone and soft tissue tumors. It may therefore be considered as a potential alternative to existing percutaneous ablation techniques in the management of bone and soft tissue tumors.