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.
Keywords: Bone Tumors; CT Guidance; Local Anesthesia; Microwave Ablation; Soft Tissue Tumors.
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