Cryoablation for the Palliation of Painful Bone Metastasis: A Systematic Review Publisher Pubmed



Khanmohammadi S^{1, 2} ; Noroozi A³ ; Yekaninejad MS⁴ ; Rezaei N^{1, 2, 5}
Source: CardioVascular and Interventional Radiology Published:2023

Abstract

Background: Cryoablation is a minimally invasive procedure to treat painful bone metastases in patients with cancer. We designed a systematic review to understand the safety and effects of cryoablation on the pain and quality of life (QoL) of cancer patients. Method: We searched PubMed, ISI, Cochrane library, and Scopus databases using the keywords “Cryoablation,” “Pain,” and “Bone metastasis.” Inclusion criteria were: (1) Original studies published until September 8, 2022; (2) studies on patients over 18 years and affected by bone metastasis; (3) bone metastasis treated with stand-alone cryoablation; (4) studies reporting patients’ pain before and at least one time-point following cryoablation; and (5) English-language studies. Results: We screened 696 articles. Fifteen studies on 376 patients were included. Time points for pain assessment ranged from 1 day to 6 months. Spine was the most frequent treated location. All studies reported a significant pain reduction between 1 day and 6 months after the cryoablation procedure. The highest mean difference between pre- and post-procedure scores was 5.8 (VAS scale) after 4 weeks. The overall rate of minor and major complications was 12.74%. Cryoablation improved the QoL of cancer patients and decreased the need for analgesics. Conclusion: Cryoablation is a safe and useful procedure for palliating painful bone metastasis and increasing the QoL of cancer patients. Future studies should adopt a standardized pain reporting scale to allow for meta-analysis. © 2023, Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).