Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jun 23;10(6):e0129021.
doi: 10.1371/journal.pone.0129021. eCollection 2015.

Treatment of Solitary Painful Osseous Metastases with Radiotherapy, Cryoablation or Combined Therapy: Propensity Matching Analysis in 175 Patients

Mario Di Staso  1 , Giovanni Luca Gravina  1 , Luigi Zugaro  2 , Pierluigi Bonfili  1 , Lorenzo Gregori  2 , Pietro Franzese  1 , Francesco Marampon  1 , Francesca Vittorini  3 , Roberto Moro  3 , Vincenzo Tombolini  4 , Ernesto Di Cesare  1 , Carlo Masciocchi  2
Affiliations

Treatment of Solitary Painful Osseous Metastases with Radiotherapy, Cryoablation or Combined Therapy: Propensity Matching Analysis in 175 Patients

Mario Di Staso et al. PLoS One. .

Abstract

Purpose: aim of this study was to identify outcomes in pain relief and quality of life in patients with a solitary painful osseous metastasis treated by radiotherapy, cryoablation or the combination using a propensity score matching study design.

Materials and methods: 175 patients with painful bone metastases were included in the study. Twenty-five of them underwent a radiation course (20 Gy in five daily fractions) 15 days after the cryoablation. These subjects were retrospectively matched by propensity analysis with a group of subjects treated by radiotherapy (125 subjects) and with a group treated byCryoablation (25 subjects). The pain relief in terms of complete response, rate of subjects requiring analgesics after treatments and the changes in self-rated quality of life were measured. Informed consent was obtained from the subject and the study was approved by the local Ethical Committee.

Results: An higher proportion of subjects treated by cryoablation (32%) or cryoablation followed by RT (72%;) experienced a complete response compared with patients treated by radiotherapy alone (11.2%). After Bonferroni correction strategy, the addition of radiotherapy to cryoablation significantly improved the rate of complete response compared with cryoablation alone (p = 0.011) and this paralleled with an improved self-rated quality of life. Seventeen subjects (13.6%) of patients in the radiotherapy group, 9 (36%) in the cryoablation group, and 19 (76)% in the cryoablation- radiotherapy group did not require narcotic medications.

Conclusions: The addition of radiotherapy to cryoablation favorably impacts on perceived pain, with a favorable toxicity profile. However, our data should be interpreted with caution and could serve as a framework around which to design future trials.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Quality of life score measured by single question from MQOL.
Self ratedQoL before (A) and after treatments (B).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Suva LJ, Washam C, Nicholas RW, Griffin RJ. 2011. Bone metastasis: mechanisms and therapeutic opportunities. Nat Rev Endocrinol 7(4):208–18. 10.1038/nrendo.2010.227 - DOI - PMC - PubMed
    1. Roodman GD. 2004. Mechanisms of bone metastasis. N Engl J Med 350:1655–1664. - PubMed
    1. Suva LJ, Griffin RJ, Makhoul I. 2009. Mechanisms of bone metastases of breast cancer. EndocrRelat Cancer 16:703–713. - PMC - PubMed
    1. Coleman RE. 2006. Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res 12:6243S–6249S. - PubMed
    1. Coleman RE. 2001. Metastatic bone disease: clinical features, pathophysiology and treatment strategies. Cancer Treat Rev 27(3):165–176. - PubMed