CT fluoroscopy-guided percutaneous osteoplasty for the treatment of osteolytic lung cancer bone metastases to the spine and pelvis

Abstract

Purpose: To retrospectively assess the results of computed tomographic (CT) fluoroscopy-guided percutaneous osteoplasty (PO) of osteolytic lung cancer bone metastases, focusing on pain reduction, improved quality of life, and patient mobility.

Materials and methods: Over a 43-month interval, 92 patients with lung cancer bone metastases underwent PO, including vertebroplasty and acetabuloplasty. A total of 261 lesions of the vertebral column and 22 lesions of the pelvis, ilium, and femur were treated with the use of CT fluoroscopic guidance. Clinical outcomes were assessed, including pain, quality of life, and mobility, 24 hours before, 24 hours after, and 1 and 3 months after osteoplasty.

Results: Pain reduction and improved quality of life and patient mobility were observed in most patients. Visual analog scale and Karnofsky Performance Scale scores changed significantly (P < .05), from 6.1 ± 1.4 and 69.3 ± 5.5 at 24 hours before osteoplasty, respectively, to 3.5 ± 1.2 and 75.2 ± 5.4 at 24 hours after the procedure, 3.3 ± 1.2 and 76.5 ± 5.8 at 1 month, and 2.9 ± 1.5 and 79.6 ± 5.8 at 3 months after PO. Mobility scale score, Frankel classification of spinal cord injury, and Harris hip score also changed significantly (P < .05) after osteoplasty. No major complications occurred.

Conclusions: PO was shown to be a highly effective and safe palliative therapy to reduce pain and improve quality of life and patient mobility, not only in vertebral metastases, but also in pelvic, iliac, and femoral metastases.