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Analgesic efficacy and safety of percutaneous thermal ablation plus cementoplasty for painful bone metastases: a systematic review and meta-analysis

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Abstract

Purpose

To conduct a systematic review and meta-analysis of publications to evaluate the analgesic efficacy and safety of percutaneous thermal ablation (PTA) plus percutaneous cementoplasty (PCP) (PTA + PCP) for painful bone metastases.

Methods

We searched PubMed, Cochrane Library and Embase for articles published up to October 2022. Outcomes were a 10-point pain scale, morphine equivalents daily dose (MEDD) and complications. A subgroup confined to spinal bone metastases was analyzed.

Results

Twenty-one articles were selected for the analysis. The 21 selected articles involved a total of 661 cases. The pooled pain scales at pre-PTA + PCP, 1 day, 1 week and 1-, 3-, and 6 months post-PTA + PCP were 7.60 (95% confidence interval [CI], 7.26–7.95, I2 = 89%), 3.30 (95% CI, 2.25–4.82, I2 = 98%), 2.58 (95% CI, 1.99–3.35, I2 = 94%), 2.02 (95% CI, 1.50–2.71, I2 = 93%), 1.78 (95% CI, 1.26–2.53, I2 = 95%), and 1.62 (95% CI, 1.14–2.31, I2 = 88%), and in the subgroup, 7.97 (95% CI, 7.45–8.52, I2 = 86%), 3.01 (95% CI, 1.43–6.33, I2 = 98%), 2.95 (95% CI, 1.93–4.51, I2 = 95%), 2.34 (95% CI, 1.82–3.01, I2 = 68%), 2.18 (95% CI, 1.57–3.03, I2 = 78%), and 2.01 (95% CI, 1.16–3.48, I2 = 86%). Mean MEDD decreased up to 3 months post-PTA + PCP in 4 articles. The overall pooled major complication rate was 4% (95% CI, 2–6%, I2 = 2%).

Conclusions

The updated systematic review and meta-analysis indicates that PTA + PCP for painful bone metastases is safe, and can lead to rapid and sustained pain reduction.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Kochi Medical School, Kochi University, Oko-cho, Kohasu, Nankoku, Kochi, 783-8505, Japan

    Tomohiro Matsumoto, Rika Yoshimatsu, Marina Osaki, Junki Shibata, Hitomi Maeda, Kana Miyatake, Yoshinori Noda, Tomoaki Yamanishi & Takuji Yamagami

  2. Department of Radiology, Kochi Health Sciences Center, 2125-1 Ike, Kochi, 781-0111, Japan

    Rika Yoshimatsu & Marina Osaki

Authors
  1. Tomohiro Matsumoto
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  2. Rika Yoshimatsu
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Tomohiro Matsumoto, Marina Osaki, Junki Shibata and Rika Yoshimatsu. The first draft of the manuscript was written by Tomohiro Matsumoto and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Tomohiro Matsumoto.

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Matsumoto, T., Yoshimatsu, R., Osaki, M. et al. Analgesic efficacy and safety of percutaneous thermal ablation plus cementoplasty for painful bone metastases: a systematic review and meta-analysis. Int J Clin Oncol 29, 372–385 (2024). https://doi.org/10.1007/s10147-023-02458-z

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  • DOI: https://doi.org/10.1007/s10147-023-02458-z

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