Does Radiofrequency Ablation and Kyphoplasty in combination with Radiation Treatment have additive effect for the Treatment of Painful Spine Metastases?

Tuesday, March 7, 2023

3:36 PM – 3:45 PM

Location: Phoenix Convention Center, 221AB

Presenting Author(s)

Kenneth Richardson, MS-3

University of Miami Medical Student
University of Miami

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

Hamed Jalaeian, MD, MS, RPVI

Assistant Professor Clinical Interventional Radiology
University of Miami Health System
Jack Lin, B.A.

University of Miami Medical Student
University of Miami
AS

Akshat Sanan, MS-4

University of Miami Medical Student
UNIVERSITY OF MIAMI
TP

Thomas Pennix, MD

Resident Physician
University of Miami
JK

Jessica G. Kumar, MD

Assistant Professor Clinical Interventional Radiology
Jackson Memorial Hospital
JL

Jeffrey Leichter, MD

Assistant Professor Clinical Interventional Radiology
The University of Miami, Miller School of Medicine

Disclosure(s):

Kenneth Richardson, MS-3: No financial relationships to disclose

Hamed Jalaeian, MD: No financial relationships to disclose

Jack Lin, B.A.: No financial relationships to disclose

Purpose:

To compare kyphoplasty ablation with and without radiotherapy for the treatment of patients with painful metastatic neoplastic disease to the spine.

Materials and Methods:

Between 3/2019 and 08/2022, 59 kyphoplasty procedure were performed for palliation of metastatic spine disease. 21 patients (36.2%) with metastatic tumor received radiation in addition to kyphoplasty/RF ablation to palliate pain: 9 patients (47.4%) had prior radiation, 2 patients (10.5%) had concurrent, and 10 patients (1.4%) had radiation therapy after. 37 painful metastatic spinal tumors were treated with kyphoplasty ablation without radiation. The primary neoplastic disease was as follows: multiple myeloma (n=17, 28.8%), breast (n=15, 25.4%), lung (n=7, 11.9%), prostate (n= 6, 10.2%), lymphoma and colorectal (each n= 3, 5.1%), urothelial (n= 2, 3.4%), thyroid, pancreas adenocarcinoma, renal cell, and metastatic adenoid cystic (each n=1, 3.3%). Pain relief was evaluated by the visual analogue scale (VAS) score, disability by the Oswestry Disability Index (ODI), performance status by the Karnofsky Performance Status Scale (KPS) score and ECOG score before and within 3-months after the procedure. The highest documented VAS, ODI, KPSS, and ECOG scores pre- and post-procedure was recorded. A P value < 0.05 was considered statistically significant.

Results: Technical success was achieved in all patients. Table 1 compares demographics, pre procedural and post procedural pain, disability, and functional scores between the two groups. The median change in VAS, ODI, KPSS, and ECOG scores from baseline to three months was not significantly different between the two groups. There were no major complications.

Conclusion:

The study suggests adding radiation therapy to kyphoplasty/RFA for palliation of metastatic neoplastic disease to the spine may not significantly change pain, disability, or performance status scores. Further studies with a larger number of subjects and longer follow-up and prospective design are needed to validate these findings.