Ablation of painful metastatic bone tumors : a systematic review

The pain is the most common problem in patients with bone metastases. It is not related to the characteristics of the tumor (type, location, number or size of metastases). Currently, the bone metastases can be treated with chemotherapy, hormonal therapy, surgery and radiotherapy, but the drugs most used in the treatment of pain are opioids. These drugs give benefit between 8 and 12 weeks and often give non-negligible toxic effects. Percutaneous techniques are varied and, when there is indication, can be used to reduce pain and dose of morphine in these patients, being safe and effective techniques already at 4 weeks of treatment. The choice of a methodical of ablation compared to another depends on the type, size and location of the lesion. Moreover, the combined treatments of ablation and cementoplastic are also useful to stabilize the bone lesion. This review article analyzes techniques and effectiveness of percutaneous treatments of skeletal metastases.