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CRYOABLATION INDICATIONS

Bone cancer

Bone cancer overview

Bone cancer is very rare: it represents about <0.2 % of all malignant tumours (the numbers vary country by country). As the name implies, malignant bone tumours are found throughout the bones of the body.

Bone cancer, also known as bone sarcoma, can be classified as primary or secondary:

  • Primary bone cancer begins in the bone
  • Secondary bone cancer begins in another organ but the cancer cells spread to the bones (~ 90/ 100,000/ year)1

Primary bone cancer can occur in any bone in the body but is very rare (<0.2% of all malignant tumours, although the numbers vary by country).

Secondary bone cancer is becoming more common as the survival rates for many cancers improve, giving more time for the cancer to spread into the bone.

20 years

Average age of bone cancer patient. 50% of cases diagnosed before the age of 59.

3rd

Bone is the 3rd most frequent site of metastases, with approx. 90 per 100,000 cases per year.

Bone tumour subtypes and use of cryoablation

Treatment options

Most of bone tumours are classified according to the presence of the disease in one area or in several areas, as this is one of the most important information in deciding what type of treatment to follow. Bone cancer is defined as2:

  • Localised if the cancer cells are confined to the bone tissue where the tumour originated.
  • Metastatic if the cancer cells have reached other parts of the body. Metastases usually affect the lungs, but can also occur in other parts of the skeleton.
  • Relapsing if it recurs after treatment in the same location as the original tumour or in another organ.

The treatment strategy depends on different aspects: type of bone cancer, stage of disease and general health status of the patient.

The most common treatments are:1, 3

  • External beam RT (EBRT)
  • Endocrine treatments
  • Surgery
  • Chemotherapy
  • Immunological therapies
  • Radiofrequency Ablation
  • Cryoablation

Clinical results – why cryoablation?

Discover cryoablation for bone metastases

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“Bone tumour cryoablation is a safe procedure with a very low rate of major complications.”

Auloge P et al. 2019. University Hospital of Strasbourg, France

Cryoablation is an effective treatment for palliating painful musculoskeletal metastases and achieving local tumour control. Recent studies have demonstrated that Cryoablation provides high efficiency in defeating malign metastatic bone tumours and a high percentage of survivals (5-year overall survival: 67.8%).4

67.8% 

5-year overall survival4

1.6 days

Short hospital stay4

Learn more about palliative bone cryoablation >

Defeat the pain with cryoablation – the MOTION study

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“Pain, especially bone pain, is the most common symptom in malignancy patients, which seriously affects the life quality of patients with cancer.”

Zhu XC et al. 2015

92%

patients achieved pain palliation with reduced need for opioids

Bone cancer

Bone metastases have significant impact on quality of life and their prevalence is increasing as survival rates for cancer patients improve.5,6

Cryoablation for Palliation of Painful Bone Metastases: The MOTION Multicentre Study (2021) has demonstrated that Cryoablation of metastatic bone tumours provided rapid and durable pain palliation, improved quality of life7,8 and offered an alternative to opioids for pain control.8,9

Learn more about MOTION study results >

Discover more clinical evidence for cryoablation >

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References:

1. Bone Sarcoma, Sarcoma Patients EuroNet, 2016. https://www.sarcoma-patients.eu/en/bone-sarcoma
2. Bone Tumour, 2018. https://www.airc.it/cancro/informazioni-tumori/guida-ai-tumori/tumore-alle-ossa
3. Coleman R, Hadji P, Body J-J, et al. Bone health in cancer: ESMO Clinical Practice Guidelines. Ann Oncol. 2020 Dec;31(12):1650-1663 doi: 10.1016/j.annonc.2020.07.019
4. Moore W, Talati R, Bhattacharji P, Bilfinger T. Five-Year Survival after Cryoablation of Stage 1 Non-Small Cell Lung Cancer in Medically Inoperable Patients. J Vasc Interv Radiol. 2015 Mar; 26(3):312-9. doi: 10.1016/j.jvir.2014.12.006
5. Auloge P, Cazzato R.L, Rousseau C, et al. Complications of Percutaneous Bone Tumor Cryoablation: A 10-year Experience. Radiology. 2019 May;291(2): 521-8. doi: 10.1148/radiol.2019181262
6. Mastier C, Gjorgjievska A, Thivolet A, et al. Musculoskeletal metastases management: the interventional Radiologist's toolbox. Semin intervent Radiol 2018;35(04): 281-289. doi: 10.1055/s-0038-1673420
7. Callstrom M.R, Dupuy D.E, Solomon S.B, et al. Percutaneous image-guided cryoablation of painful metastases involving bone: multicenter trial. Cancer. 2013 Mar 1;119(5):1033-41. doi: 10.1002/cncr.27793
8. Tomasian A, Wallace A, Northrup B, Hillen T.J, Jenningset. Spine Cryoablation: Pain Palliation and Local Tumor Control for Vertebral Metastases. American Journal of Neuroradiology. January 2016;37 (1) 189-195; doi: 10.3174/ajnr.a4521
9. Kurup N, Morris J M, Callstrom M R. Ablation of Musculoskeletal Metastases, American Journal of Roentgenology. 2017;209: 713-721. doi: 10.2214/AJR.17.18527
10. Jennings J W , Prologo J D, Garnon J, et al. Cryoablation for Palliation of Painful Bone Metastases: The MOTION Multicenter Study. Radiol Imaging Cance. 2021 Feb 12. doi: 10.1148/rycan.2021200101
A. Jiang W, Rixiati Y, Zhao B, et al. Incidence, prevalence, and outcomes of systemic malignancy with bone metastases. J Orthop Surg (Hong Kong). Jan-Apr 2020;28(2):2309499020915989.  doi: 10.1177%2F2309499020915989
B. Bone Metastasis, Mayo Clinic, April 2021.
C. Coleman R, et al. 2020; See note n. 3.
D. Garnon J, Koch G, Caudrelier J, et al. Expanding the borders: Image-guided procedures for the treatment of musculoskeletal tumors. Diagn Interv Imaging. 2017 Sep;98(9):635-644. doi: 10.1016/j.diii.2017.07.009
E. Kurup N, et al. 2017. See note n. 9.
F. Gennaro, N., Sconfienza, L.M., Ambrogi, F. et al. Thermal ablation to relieve pain from metastatic bone disease: a systematic review. Skeletal Radiol 48, 1161–1169 (2019). Doi: 10.1007/s00256-018-3140-0
G. Amadeo B, Penel N, Coindre J-M, et al. Incidence and time trends of sarcoma(2000–2013): results from the French network of cancer registries (FRANCIM). BMC Cancer. 2020. 20:190. doi: 10.1186/s12885-020-6683-0
H. Casali P.G, Bielak S, Abecassis et al. Bone sarcomas: ESMO–PaedCan–EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018 Oct 1;29(Suppl 4):iv79-iv95. doi: https://doi.org/10.1093/annonc/mdy310
I. Bone Sarcoma, Sarcoma Patients EuroNet, 2016. See note n. 1.
J. Edwig Sarcoma, Rare Disease Database. https://rarediseases.org/rare-diseases/ewing-sarcoma/
K. Edwig Sarcoma, Sarcoma Patients EuroNet, 2016. https://www.sarcoma-patients.eu/en/bone-sarcoma/bone-cancer-research-2
L. Lindquester, W.S., Crowley, J. & Hawkins, C.M. Percutaneous thermal ablation for treatment of osteoid osteoma: a systematic review and analysis. Skeletal Radiol 49, 1403–1411 (2020). doi: 10.1007/s00256-020-03435-7
M. Poullain, F., Mattei, J., Rochwerger, A. et al. Percutaneous cryoablation of osteoblastoma in the proximal femur. Skeletal Radiol 49, 1467–1471 (2020). doi: 10.1007/s00256-020-03413-z
N. Cazzato R.L., Auloge P, Dilili D, et al. Percutaneous Image-Guided Cryoablation of Osteoblastoma. American Journal of Roentgenology. 2019;213: 1157-1162. doi: https://doi.org/10.2214/ajr.19.21390
O. Dickey I. D, et al. Solitary Osteochondroma, Medscape. Aug 12, 2021. https://emedicine.medscape.com/article/1256477-overview
P. Saglik Y, Altay M, Unal V.S, et al. Manifestations and management of osteochondromas: a retrospective analysis of 382 patients. Acta Orthop Belg. 2006 Dec;72(6):748-55. https://pubmed.ncbi.nlm.nih.gov/17260614/
Q. Librodo G, et al. Osteoid Osteoma, Medscape. Aug 12, 2021. https://emedicine.medscape.com/article/1253443-overview#a5
R. Watts E. Osteoid Osteoma, Ortho Bullets. June 19, 2021. https://www.orthobullets.com/pathology/8012/osteoid-osteoma
S. Vadera S, Gaillard F. Osteoid Osteoma, Radiopaedia. 2021. https://radiopaedia.org/articles/osteoid-osteoma?lang=gb
T. Shetty N, Hegdel P, Singh H, Gulia A. Aneurysmal Bone Cyst – Review. JBST Jan-April 202. Page 17-20. DOI: 10.13107/jbst.2020.v06i01.009
U. Tedesco N, et al. Aneurysmal Bone Cyst, Medscape. Apr 20, 2021. https://emedicine.medscape.com/article/1254784-overview#a7
V. Bone Cancer (Sarcoma), The University of Kansas, Cancer Center. https://www.kucancercenter.org/cancer/cancer-types/bone-cancer-sarcoma/bone-cancer-types
W. Park H.Y, Yang S.K, Sheppard W.L. et al. Current management of aneurysmal bone cysts. Curr Rev Musculoskelet Med. 2016 Dec; 9(4): 435–444. doi: https://dx.doi.org/10.1007%2Fs12178-016-9371-6
X. Schreuder H.W.B, Veth R.P.H, et al. Aneurysmal bone cysts treated by curettage, cryotherapy and bone grafting. The Journal of Bone and Joint Surgery. British volume Vol. 79-B, No. 1. Oncology. Doi: 10.1302/0301-620X.79B1.0790020

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