Visceral and soft-tissue tumors: Radiofrequency and alcohol ablation for pain relief - Initial experience

Rashmi T. Nair, Eric VanSonnenberg, Sridhar Shankar, Paul R. Morrison, Ritu Randhawa Gill, Kemal Tuncali, Stuart G. Silverman

Research output: Contribution to journalArticle

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Abstract

Purpose: To determine retrospectively the effectiveness of percutaneous radiofrequency ablation (RFA) alone, alcohol ablation alone, or combined RFA and alcohol ablation (hereafter, combined ablation) to treat pain in patients with visceral and soft-tissue malignancies. Materials and Methods: This HIPAA-compliant study was institutional review board approved; the informed consent requirement was waived. Twenty patients, with 28 tumors, who underwent percutaneous computed tomography (CT) or magnetic resonance (MR)-guided RFA and/or alcohol ablation for pain relief over a 2-year period were retrospectively identified, and their medical and imaging data were studied: Nineteen patients were referred for ablation because of persistent pain despite use of analgesics, and one patient had refused analgesics. The 28 tumors were located in the liver, lung, adrenal gland, retroperitoneum, gluteal muscle, inguinal mass, and subcutaneous tissues on the back. Fifteen tumors were treated with RFA alone, 12 were treated with combined ablation (when lesions were > 4 cm in diameter, except in lung or renal tumors), and one was treated with alcohol ablation alone. Pain was quantified on a 0-10 scale before, 1 day after, and 1-6 weeks after ablation. On the basis of changes in pain score and pain medication use, pain was reported with a composite measure as complete, partial, or no pain response. Quantitative pain scale values were compared by using Friedman and Tukey post hoc tests to assess significant changes. Results: At 1-6-week follow-up, pain relief was complete in nine patients (45%) and partial in six (30%); pain relief did not occur in five patients (25%). There was a significant (P < .05) decrease in pain at 1-day and 1-6-week follow-up compared with pain at baseline. Three adverse events were caused by therapy: Two were major complications (femoral neuropathy in one patient, perinephric hematoma and hemobilia in one patient), and one was a side effect of ablation (right shoulder pain) that resolved spontaneously. Conclusion: Percutaneous RFA alone or in combination with alcohol ablation provided pain relief from visceral tumors in most patients with intractable pain.

Original languageEnglish (US)
Pages (from-to)1067-1076
Number of pages10
JournalRadiology
Volume248
Issue number3
DOIs
StatePublished - Sep 1 2008

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Alcohols
Pain
Neoplasms
Analgesics
Femoral Neuropathy
Hemobilia
Health Insurance Portability and Accountability Act
Intractable Pain
Lung
Shoulder Pain
Groin
Research Ethics Committees
Subcutaneous Tissue
Diagnostic Imaging
Adrenal Glands
Informed Consent
Hematoma
Magnetic Resonance Spectroscopy
Tomography
Kidney

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Nair, R. T., VanSonnenberg, E., Shankar, S., Morrison, P. R., Gill, R. R., Tuncali, K., & Silverman, S. G. (2008). Visceral and soft-tissue tumors: Radiofrequency and alcohol ablation for pain relief - Initial experience. Radiology, 248(3), 1067-1076. https://doi.org/10.1148/radiol.2483061883

Visceral and soft-tissue tumors : Radiofrequency and alcohol ablation for pain relief - Initial experience. / Nair, Rashmi T.; VanSonnenberg, Eric; Shankar, Sridhar; Morrison, Paul R.; Gill, Ritu Randhawa; Tuncali, Kemal; Silverman, Stuart G.

In: Radiology, Vol. 248, No. 3, 01.09.2008, p. 1067-1076.

Research output: Contribution to journalArticle

Nair, RT, VanSonnenberg, E, Shankar, S, Morrison, PR, Gill, RR, Tuncali, K & Silverman, SG 2008, 'Visceral and soft-tissue tumors: Radiofrequency and alcohol ablation for pain relief - Initial experience', Radiology, vol. 248, no. 3, pp. 1067-1076. https://doi.org/10.1148/radiol.2483061883
Nair, Rashmi T. ; VanSonnenberg, Eric ; Shankar, Sridhar ; Morrison, Paul R. ; Gill, Ritu Randhawa ; Tuncali, Kemal ; Silverman, Stuart G. / Visceral and soft-tissue tumors : Radiofrequency and alcohol ablation for pain relief - Initial experience. In: Radiology. 2008 ; Vol. 248, No. 3. pp. 1067-1076.
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abstract = "Purpose: To determine retrospectively the effectiveness of percutaneous radiofrequency ablation (RFA) alone, alcohol ablation alone, or combined RFA and alcohol ablation (hereafter, combined ablation) to treat pain in patients with visceral and soft-tissue malignancies. Materials and Methods: This HIPAA-compliant study was institutional review board approved; the informed consent requirement was waived. Twenty patients, with 28 tumors, who underwent percutaneous computed tomography (CT) or magnetic resonance (MR)-guided RFA and/or alcohol ablation for pain relief over a 2-year period were retrospectively identified, and their medical and imaging data were studied: Nineteen patients were referred for ablation because of persistent pain despite use of analgesics, and one patient had refused analgesics. The 28 tumors were located in the liver, lung, adrenal gland, retroperitoneum, gluteal muscle, inguinal mass, and subcutaneous tissues on the back. Fifteen tumors were treated with RFA alone, 12 were treated with combined ablation (when lesions were > 4 cm in diameter, except in lung or renal tumors), and one was treated with alcohol ablation alone. Pain was quantified on a 0-10 scale before, 1 day after, and 1-6 weeks after ablation. On the basis of changes in pain score and pain medication use, pain was reported with a composite measure as complete, partial, or no pain response. Quantitative pain scale values were compared by using Friedman and Tukey post hoc tests to assess significant changes. Results: At 1-6-week follow-up, pain relief was complete in nine patients (45{\%}) and partial in six (30{\%}); pain relief did not occur in five patients (25{\%}). There was a significant (P < .05) decrease in pain at 1-day and 1-6-week follow-up compared with pain at baseline. Three adverse events were caused by therapy: Two were major complications (femoral neuropathy in one patient, perinephric hematoma and hemobilia in one patient), and one was a side effect of ablation (right shoulder pain) that resolved spontaneously. Conclusion: Percutaneous RFA alone or in combination with alcohol ablation provided pain relief from visceral tumors in most patients with intractable pain.",
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AU - Morrison, Paul R.

AU - Gill, Ritu Randhawa

AU - Tuncali, Kemal

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N2 - Purpose: To determine retrospectively the effectiveness of percutaneous radiofrequency ablation (RFA) alone, alcohol ablation alone, or combined RFA and alcohol ablation (hereafter, combined ablation) to treat pain in patients with visceral and soft-tissue malignancies. Materials and Methods: This HIPAA-compliant study was institutional review board approved; the informed consent requirement was waived. Twenty patients, with 28 tumors, who underwent percutaneous computed tomography (CT) or magnetic resonance (MR)-guided RFA and/or alcohol ablation for pain relief over a 2-year period were retrospectively identified, and their medical and imaging data were studied: Nineteen patients were referred for ablation because of persistent pain despite use of analgesics, and one patient had refused analgesics. The 28 tumors were located in the liver, lung, adrenal gland, retroperitoneum, gluteal muscle, inguinal mass, and subcutaneous tissues on the back. Fifteen tumors were treated with RFA alone, 12 were treated with combined ablation (when lesions were > 4 cm in diameter, except in lung or renal tumors), and one was treated with alcohol ablation alone. Pain was quantified on a 0-10 scale before, 1 day after, and 1-6 weeks after ablation. On the basis of changes in pain score and pain medication use, pain was reported with a composite measure as complete, partial, or no pain response. Quantitative pain scale values were compared by using Friedman and Tukey post hoc tests to assess significant changes. Results: At 1-6-week follow-up, pain relief was complete in nine patients (45%) and partial in six (30%); pain relief did not occur in five patients (25%). There was a significant (P < .05) decrease in pain at 1-day and 1-6-week follow-up compared with pain at baseline. Three adverse events were caused by therapy: Two were major complications (femoral neuropathy in one patient, perinephric hematoma and hemobilia in one patient), and one was a side effect of ablation (right shoulder pain) that resolved spontaneously. Conclusion: Percutaneous RFA alone or in combination with alcohol ablation provided pain relief from visceral tumors in most patients with intractable pain.

AB - Purpose: To determine retrospectively the effectiveness of percutaneous radiofrequency ablation (RFA) alone, alcohol ablation alone, or combined RFA and alcohol ablation (hereafter, combined ablation) to treat pain in patients with visceral and soft-tissue malignancies. Materials and Methods: This HIPAA-compliant study was institutional review board approved; the informed consent requirement was waived. Twenty patients, with 28 tumors, who underwent percutaneous computed tomography (CT) or magnetic resonance (MR)-guided RFA and/or alcohol ablation for pain relief over a 2-year period were retrospectively identified, and their medical and imaging data were studied: Nineteen patients were referred for ablation because of persistent pain despite use of analgesics, and one patient had refused analgesics. The 28 tumors were located in the liver, lung, adrenal gland, retroperitoneum, gluteal muscle, inguinal mass, and subcutaneous tissues on the back. Fifteen tumors were treated with RFA alone, 12 were treated with combined ablation (when lesions were > 4 cm in diameter, except in lung or renal tumors), and one was treated with alcohol ablation alone. Pain was quantified on a 0-10 scale before, 1 day after, and 1-6 weeks after ablation. On the basis of changes in pain score and pain medication use, pain was reported with a composite measure as complete, partial, or no pain response. Quantitative pain scale values were compared by using Friedman and Tukey post hoc tests to assess significant changes. Results: At 1-6-week follow-up, pain relief was complete in nine patients (45%) and partial in six (30%); pain relief did not occur in five patients (25%). There was a significant (P < .05) decrease in pain at 1-day and 1-6-week follow-up compared with pain at baseline. Three adverse events were caused by therapy: Two were major complications (femoral neuropathy in one patient, perinephric hematoma and hemobilia in one patient), and one was a side effect of ablation (right shoulder pain) that resolved spontaneously. Conclusion: Percutaneous RFA alone or in combination with alcohol ablation provided pain relief from visceral tumors in most patients with intractable pain.

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