Assessing long-term locoregional control of spinal osseous metastases after microwave ablation. (October 2022)

• Record Type: Journal Article
• Authors: Motaghi, Mina; England, Ryan W.; Nejad, Nima Hafezi; Sankaran, Nisha; Patel, Akash M.; Khan, Majid A.
• Is Part Of: Journal of clinical neuroscience. Volume 104(2022)
• Page Start: 48
• Page End: 55
• Publication Date: 2022-10
• Subjects: Spinal metastasis -- Microwave ablation technique -- Radiofrequency ablation -- Local tumor control -- Oligometastases -- Spinal neoplasm -- Ablation technique; PET/CT Positron Emission Tomography ? Computer Tomography -- MWA MIcrowave Ablation -- VAS Visual Analogue Scale -- ESCC Epidural Spinal Cord Compression -- RT/ SBRT Radiation therapy/ Stereotactic body Radiation therapy; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2022.07.025
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Microwave ablation is a safe ablation technique for treating spinal metastasis. Microwave ablation is an effective technique for pain palliation in patients with spinal metastasis. Microwave ablation as an effective technique for long-term locoregional tumor control of oligometastatic spinal disease. Abstract: Osseous metastases to the spine result in significant pain and decreased quality of life. The purpose of this study was to evaluate the long-term efficacy of microwave ablation (MWA) for the treatment of spinal metastases regarding pain reduction and local control of disease progression. In this single center retrospective study, patients with osseous metastases to the spine undergoing MWA with vertebroplasty from 2013 to 2020 were included. Locoregional control of metabolic activity at the treated level was assessed using PET/CT scan both pre- and post-procedure. Pain reduction was measured using change in visual analog scale (VAS) pain score. Forty-eight spinal levels were treated with MWA in 28 patients (57 % male, mean age 68 ± 9 years). Median ablation time, energy, and temperature were 4 min and 13 s, 3.6 kJ, and 80 °C, respectively. Median pre-procedure maximum standard uptake value (SUVmax) was significantly reduced following ablation, from 4.55 (IQR 3.65–6.1) to 0 (IQR 0–1.8; p < 0.001), over an average of 29 ± 14.1 month follow up period. Pre-procedure VAS pain score was reduced from median (IQR) of 8 (6.5–9) to 1(1–2), 2(1–3) and 1(0.5–3) at 24 h, four weeks, and six months post-procedure, respectively (all p < 0.001 with respect to pre-procedure scores). In conclusion, this study supports microwave ablation as an effective technique for pain palliation and long-term locoregional tumor control of oligometastatic spinal disease as assessed by metabolic response.