From: "Dr. D. Kossove" <doctordee@telkomsa.net>
Subject: some places where bone RFA is done
Date: Monday, January 19, 2004 9:14 PM

Date:    Mon, 19 Jan 2004 15:16:58 -0800
From:    Dick Whiting <dwhiting@EUROPA.COM>
Subject: Re: article on RFA of bone mets

All,

On Monday, January 19, 2004, Dr. D. Kossove wrote:

> Percutaneous Image-Guided Radiofrequency Ablation of Painful Metastases
> Involving Bone: A Multicenter Study

This study is exciting to me for a couple reasons. The first is that it
lists locations that are NOW doing RFA of bone mets. The second is that in
June 2001, I located a reference that this procedure was possible, called
the article's author at M.D. Anderson, and was told that no one was REALLY
doing bone mets except for Dr. Dupuy at Brown University. We called him and
he explained what was entailed and we convinced a local radiation guy to
attempt the procedure for a met in Regina's humerus and one in her femur.
Now, 2 1/2 years later the procedure seems to be much more widely available
and this study will provide support for patients requesting RFA in bone
mets.


Dick

My disclaimer: I have expertise in carpentry, computers, and children, NOT
medicine, genetics, pathology,...

--
Homepage: http://www.europa.com/~dwhiting Last Updated: February 14, 2003



Date:    Mon, 19 Jan 2004 10:34:10 -0800
From:    "Dr. D. Kossove" <doctordee@TELKOMSA.NET>
Subject: article on RFA of bone mets

http://www.jco.org/cgi/content/abstract/22/2/300

Journal of Clinical Oncology, Vol 22, No 2 (January 15), 2004: pp. 300-306
 2004 American Society for Clinical Oncology
DOI: 10.1200/JCO.2004.03.097
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Percutaneous Image-Guided Radiofrequency Ablation of Painful Metastases
Involving Bone: A Multicenter Study
Matthew P. Goetz, Matthew R. Callstrom, J. William Charboneau, Michael A.
Farrell, Timothy P. Maus, Timothy J. Welch, Gilbert Y. Wong, Jeff A. Sloan,
Paul J. Novotny, Ivy A. Petersen, Robert A. Beres, Daniele Regge, Rodolfo
Capanna, Mark B. Saker, Dietrich H.W. Grnemeyer, Athour Gevargez, Kamran
Ahrar, Michael A. Choti, Thierry J. de Baere, Joseph Rubin
From the Departments of Oncology, Diagnostic Radiology, Anesthesiology,
Biostatistics, and Radiation Oncology, Mayo Clinic, Rochester, MN; St Luke's
Hospital, Milwaukee, WI; Institute for Cancer Research and Treatment,
Torino; Department of Orthopaedic Oncology, CTO, Florence, Italy; Department
of Radiology, Northwestern University Medical School, Chicago, IL; Institut
for Microtherapy, Department of Radiology and Microtherapy, University
Witten/Herdecke, Germany; Department of Radiology, M.D. Anderson Cancer
Center, Houston, TX; Department of Surgery, The Johns Hopkins University
School of Medicine, Baltimore, MD; Department of Radiology, Institut Gustave
Roussy, Villejuif, France

Address reprint requests to J. William Charboneau, MD, Department of
Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905; e-mail:
charboneau.william@mayo.edu

PURPOSE: Few options are available for pain relief in patients with bone
metastases who fail standard treatments. We sought to determine the benefit
of radiofrequency ablation (RFA) in providing pain relief for patients with
refractory pain secondary to metastases involving bone.

PATIENTS AND METHODS: Thirty-one US and 12 European patients with painful
osteolytic metastases involving bone were treated with image-guided RFA
using a multitip needle. Treated patients had  4/10 pain and had either
failed or were poor candidates for standard treatments such as radiation or
opioid analgesics. Using the Brief Pain InventoryShort Form, worst pain
intensity was the primary end point, with a 2-unit drop considered
clinically significant.

RESULTS: Forty-three patients were treated (median follow-up, 16 weeks).
Before RFA, the mean score for worst pain was 7.9 (range, 4/10 to 10/10).
Four, 12, and 24 weeks following treatment, worst pain decreased to 4.5 (P <
.0001), 3.0 (P < .0001), and 1.4 (P = .0005), respectively. Ninety-five
percent (41 of 43 patients) experienced a decrease in pain that was
considered clinically significant. Opioid usage significantly decreased at
weeks 8 and 12. Adverse events were seen in 3 patients and included (1) a
second-degree skin burn at the grounding pad site, (2) transient bowel and
bladder incontinence following treatment of a metastasis involving the
sacrum, and (3) a fracture of the acetabulum following RFA of an acetabular
lesion.

CONCLUSION: RFA of painful osteolytic metastases provides significant pain
relief for cancer patients who have failed standard treatments.

Supported in part by RITA Medical Systems, Mountain View, CA

Presented in part at the American Society of Clinical Oncology 2002 Annual
Meeting (May 18-21, 2002, Orlando, FL) and the Radiological Society of North
America 2002 Annual Meeting, December 1-6, 2002, Chicago, IL.

M.P.G. and M.R.C. contributed equally to this article.

Authors' disclosures of potential conflicts of interest are found at the end
of this article.

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