Cryoablation safe and effective for pain control in sternal metastases

1. Among patients with metastatic cancer to the sternum, the use of cryoablation was associated with significant pain relief lasting an average of multiple months.

2. Control of local malignant disease using cryoablation in select patients was found to be safe and technically feasible without major complications.

Evidence Rating Level: 3 (Average)

Study Rundown: The principal treatment goal for many metastatic cancers is palliation, with the aim of maintaining or improving the quality of life and possibly prolonging survival. Among many palliative treatment options currently available to patients, cryoablation offers a non-surgical, localized treatment that targets the tumor tissue by damaging it with extreme cold temperature, while sparing the adjacent healthy tissue. This technique is currently being used to treat metastatic bone lesions, for local tumor control, and for pain relief in patients with multiple different tumor types.

The goal of this study was to assess the technical safety and efficacy of cryoablation for pain relief in patients with metastatic tumors in the sternum. Hospital records were reviewed and, in patients who underwent cryoablation for sternal metastases, patient-reported pain relief scores showed significant post-procedure improvement. The study’s primary limitations were the small number of patients enrolled and the retrospective design. Additionally, one patient suffered an infectious complication which was successfully treated by antibiotics; however, due to the small sample size of the study, this patient represents a large percentage of the overall study population. Further work is necessary to prospectively replicate these findings at other centers using a larger patient cohort.

Click to read the study in the Journal of Vascular and Interventional Radiology

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Relevant Reading: Breast cryoablation in patients with bone metastatic breast cancer (Journal of Vascular and Interventional Radiology)

In-Depth [retrospective cohort]: This study retrospectively reviewed hospital records of sternal cryoablation procedures performed between January, 2005 and June, 2013. Complications, local tumor control, and pain relief were recorded in a total of 12 patients (5 men, 7 women; aged 38—80 years) with known metastatic cancer within the sternum. Mean pain scores showed significant improvement from 7.0 to 1.9 post-cryoablation (p = .00049) with a median pain relief duration of 5.7 months (range, 1.5–14.7 months). Local tumor control was achieved in 80% of patients who underwent repeat treatment. One minor, uncomplicated operative site infection was recorded, and the affected patient experienced complete resolution of symptoms with antibiotic therapy alone.

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