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Cryoablation for the Palliation of Painful Bone Metastasis: A Systematic Review

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Abstract

Background

Cryoablation is a minimally invasive procedure to treat painful bone metastases in patients with cancer. We designed a systematic review to understand the safety and effects of cryoablation on the pain and quality of life (QoL) of cancer patients.

Method

We searched PubMed, ISI, Cochrane library, and Scopus databases using the keywords “Cryoablation,” “Pain,” and “Bone metastasis.” Inclusion criteria were: (1) Original studies published until September 8, 2022; (2) studies on patients over 18 years and affected by bone metastasis; (3) bone metastasis treated with stand-alone cryoablation; (4) studies reporting patients’ pain before and at least one time-point following cryoablation; and (5) English-language studies.

Results

We screened 696 articles. Fifteen studies on 376 patients were included. Time points for pain assessment ranged from 1 day to 6 months. Spine was the most frequent treated location. All studies reported a significant pain reduction between 1 day and 6 months after the cryoablation procedure. The highest mean difference between pre- and post-procedure scores was 5.8 (VAS scale) after 4 weeks. The overall rate of minor and major complications was 12.74%. Cryoablation improved the QoL of cancer patients and decreased the need for analgesics.

Conclusion

Cryoablation is a safe and useful procedure for palliating painful bone metastasis and increasing the QoL of cancer patients. Future studies should adopt a standardized pain reporting scale to allow for meta-analysis.

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Acknowledgements

This study was supported by a Grant from Tehran University of Medical Sciences (63742).

Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Qarib St., Keshavarz Blvd., Tehran, Iran

    Shaghayegh Khanmohammadi & Nima Rezaei

  2. Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran

    Shaghayegh Khanmohammadi & Nima Rezaei

  3. School of Medicine, Islamic Azad University, Tehran, Iran

    Alireza Noroozi

  4. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Poursina St., Keshavarz Blvd., Tehran, Iran

    Mir Saeed Yekaninejad

  5. Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Nima Rezaei

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  1. Shaghayegh Khanmohammadi
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  2. Alireza Noroozi
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  3. Mir Saeed Yekaninejad
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  4. Nima Rezaei
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Correspondence to Mir Saeed Yekaninejad or Nima Rezaei.

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Khanmohammadi, S., Noroozi, A., Yekaninejad, M.S. et al. Cryoablation for the Palliation of Painful Bone Metastasis: A Systematic Review. Cardiovasc Intervent Radiol 46, 1469–1482 (2023). https://doi.org/10.1007/s00270-022-03356-z

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  • DOI: https://doi.org/10.1007/s00270-022-03356-z

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