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28 februari 2012: Bron: Cancer. Cancer. 2010 February 15; 116(4): 989–997. doi:  10.1002/cncr.24837

Uit een studie uit 2002 bleek dat 95% van de patiënten significante pijnverlichting ervaart na een behandeling met RFA - Radio Frequency Ablation. Bij 69% hield deze pijnverlichting tot een half jaar na de RFA behandeling aan. Vorig jaar werd een studie gepubliceerd waarbij RFA werd toegepast bij 50 patiënten met botuitzaaiïngen die daaraan veel pijn hadden. De RFA werd ingezet om de pijn te verlichten en deze studie toont aan dat RFA een heel goede behandeling kan zijn voor pijnverlichting veroorzaakt door bottumoren. Tot zelfs 8 cm. in doorsnee konden bottumoren worden weggehaald.

Resultaten
Bij 55 patiënten werd een volledige RFA uitgevoerd. Slechts bij 3 patiënten (5%) ontstonden complicaties met een graad 3.  De RFA behandeling zorgde bij alle patiënten voor minder pijn op zowel  1 en 3 maanden voor alle aan pijn gerelateerde doelstellingen van de studie. De gemiddelde vermindering van de pijn van voor de RFA behandeling bij de meting na 1 maand bleek 26,27
(95% BI, 17,65 tot 34,89, P <0,0001) en de toename van de pijnvermindering voor de RFA behandeling op meting na 3 maanden follow-up is 16.38 (95 % BI, 3,37 tot 29,39, P = 0,02).
De gemiddelde afname van de intensiteit van de pijn van voor de RFA na 1 maand follow-up was 26,9 (p <0,0001) en 14,2 na 3 maanden follow-up (p = 0,02).
De kans om minder ernstige pijn te hebben  na 1 maand follow-up is 14.03 keer hoger vergeleken met voor de RFA (95% BI, 2,33 tot 25,73, P <0,0001), en de kans na 3 maanden follow-up is 8,00 keer hoger in vergelijking met voor de RFA (95% BI, 0,85 tot 15,15, P <0,001).
De gemiddelde stijging van het welbevinden van de patiënt van voor de RFA na 1 maand follow-up was 19,9 (P <0,0001) en 14,9 na 3 maanden follow-up (p = 0,005).

Conclusie:
De onderzoekers wijzen er met nadruk op dat RFA - Radio Frequency Ablation een veilig behandeling is die de pijn kan verzachten van botmetastasen.

Hieronder het abstract van de studie. Als u hier klikt kunt u het volledige studierapport gratis inzien. Plus een referentielijst van gerelateerde studies.

RFA - Radio frequency Ablation can safely palliate pain from bone metastases

Cancer. Author manuscript; available in PMC 2011 February 15.
Published in final edited form as:
PMCID: PMC2819592
NIHMSID: NIHMS158485
Percutaneous Radiofrequency Ablation of Painful Osseous Metastases: A Multi-center American College of Radiology Imaging Network Trial
Damian E. Dupuy, M.D.,1 Dawei Liu, Ph.D.,9 Donna Hartfeil, RN,5 Lucy Hanna, Ph.D.,4 Jeffrey D. Blume, Ph.D.,4,8 Kamran Ahrar, M.D.,6 Robert Lopez, M.D.,7 Howard Safran, M.D.,2 and Thomas DiPetrillo, M.D.3
1 Department of Diagnostic Imaging, The Warren Alpert Medical School at Brown University
2 Department of Hematology/Oncology, The Warren Alpert Medical School at Brown University
3 Department of Radiation Medicine, The Warren Alpert Medical School at Brown University
4 Center for Statistical Sciences, Brown University
5 American College of Radiology Imaging Network (ACRIN)
6 MD Anderson Cancer Center
7 University of Alabama at Birmingham Medical Center
8 Department of Biostatistics, Vanderbilt University School of Medicine
9 Department of Statistics, Unversity of Iowa
Corresponding Author: Damian E. Dupuy, M.D., Department of Diagnostic Imaging, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903, Tel. 401-444-5184, Fax 401-444-5017, ddupuy@lifespan.org
Background
To determine if radiofrequency ablation (RFA) can safely reduce pain from osseous metastatic disease.
Methods
A single arm prospective trial in patients with a single painful bone metastasis with unremitting pain of at least a score above 50 on a pain scale of 0–100. Percutaneous CT guided RFA of the bone metastasis to temperatures above 60 degrees Celsius was performed.
Endpoints were the toxicity and pain effects of RFA before and at 2 weeks, one and three months after RFA.
Results
55 patients completed RFA. Grade 3 toxicities occurred in 3 of 55 patients (5%). RFA reduced pain at 1- and 3-month for all pain assessment measures. The average increase in pain relief from pre-RFA to 1-month follow-up is 26.27 (95% CI, 17.65 to 34.89, P<0.0001) and the increase from pre-RFA to 3-month follow-up is 16.38 (95% CI, 3.37 to 29.39, P=0.02). The average decrease in pain intensity from pre-RFA to 1-month follow-up was 26.9 (P<0.0001) and 14.2 for 3-month follow-up (P=0.02). The odds of being in lower pain severity at 1-month follow-up is 14.03 (95% CI, 2.33 to 25.73, P<0.0001) times higher than that at pre-RFA, and the odds at 3-month follow-up is 8.00 (95% CI, 0.85 to 15.15, P<0.001) times higher than that at pre-RFA. The average increase in mood from pre-RFA to 1-month follow-up was 19.9 (P<0.0001) and 14.9 for 3-month follow-up (P=0.005).
Conclusion
This cooperative group trial strongly suggests that RFA can safely palliate pain from bone metastases.
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