Cryoablation combined with zoledronic acid in comparison with cryoablation and zoledronic acid alone in the treatment of painful bone metastases

Abstract

This study aimed to examine the efficacy and safety of cryoablation, combined with zoledronic acid or alone, in the treatment of bone metastatic pain. A total of 84 patients were randomly divided into three groups: group A (cryoablation plus zoledronic acid), group B (cryoablation) and group C (zoledronic acid). In group A, the overall response [OR = complete response (CR) + partial response (PR)] was 85.7% (24/28), the CR was 35.7% (10/28) and the PR was 50.0% (14/28). In group B, the OR was 50.0% (14/28), the CR was 14.3% (4/28) and the PR was 35.7% (10/28). In group C, the OR was 67.9% (19/28), the CR was 21.4% (6/28) and the PR was 46.4% (13/28). The differences in OR, CR and PR among the three groups were statistically significant (P<0.05). The mean onset time of pain relief for the cryoablation combined with zoledronic acid treatment group was 1.96±2.26 days, for cryoablation treatment alone was 1.43±1.79 days and for zoledronic acid alone was 11.67±3.14 days; there were statistically significant differences among the three groups (P<0.05). The response duration was 146.68±1.89 days in group A, 71.60±2.94 days in group B and 112.99±1.37 days in group C; the differences among the three groups were statistically significant (P<0.01). In conclusion, cryoablation combined with zoledronic acid is an effective and safe therapeutic strategy for the treatment of bone metastatic pain.

Keywords: bone metastases; cryoablation; efficacy; pain; zoledronic acid.

Figure 1

Lung cancer with rib and vertebral metastasis and bone destruction, during the ablation procedure. CT scans showing (A) the insertion of cryoprobes into metastatic lesions and (B) the monitoring of the area of ablation, and (C) ensuring the ablation area completely covers the lesion. CT, computed tomography.

Figure 2

Breast cancer with lumbar vertebral metastasis. (A) The soft tissue tumor and lesion of the lumbar vertebral prior to the ablation procedure; (B) the ablation area completely covered the lesions.

Figure 3

Lung squamous carcinoma with rib metastasis. (A) Cryoprobes inserted into metastatic lesions under CT scan; (B) monitoring the area of ablation by CT scan. CT, computed tomography.