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
Most commonly occurs in the spine, pelvis and thigh; associated with fracture and pain - Tx usually focused on slowing growth/ improving QoL, rather than cureB
Incidence (per 100,00 per year): 90A
Use of cryoablation:
- CA included in ESMO guidelines as a special consideration for relieving pain from spinal metastasesC
- Large multicentre studies also support use of CA for pain palliationD,E,F
Usually arises in the metaphysis of a long bone, most commonly around the knee; occurs most frequently in adolescentsI
Incidence (per 100,00 per year): 0.27G (0.8-1.1H)
Use of cryoablation:
Cryotherapy included in ESMO guidelines as alternative option for patients unfit for surgery who have recurrent osteosarcoma lung metastasesH
Mostly found in legs & arms (50%) and the pelvic bones (25%), followed by the ribs and spine; occurs most frequently in children and adolescentsI
Incidence (per 100,00 per year): 0.28GH (2.93J)
Use of cryoablation: N/A (TBC)
Bone sarcoma that develops in the cartilage cells with the most common sites being the upper arm, pelvis and thigh bone; usually affects adults above the age of 40K
Incidence (per 100,00 per year): 0.2-0.41G,H
Use of cryoablation:
Cryotherapy included in ESMO guidelines as a local adjuvant to curettage for Grade 1 atypical cartilaginous tumours (intermediate – locally aggressive)H
Rare spinal tumours that usually develop around the neck or pelvis; most commonly affects adults in their 40’s and 50’sK
Incidence (per 100,00 per year): 0.05-0.12G,H
Use of cryoablation:
CA included in ESMO guidelines as a pain palliation Tx for recurrent extracranial chordomasH
Benign tumours that predominantly occur in the long bones of the arms and legs (always found at the end of the bone next to the joint); most frequent in young adultsK
Incidence (per 100,00 per year): 0.1H
Use of cryoablation:
Retrospective studies support use of CA for Tx of benign/ intermediate bone tumoursL,M,N
(Incidence of all benign bone tumour subtypes is ~ 2.6/ 100,000/year*)
- Cryotherapy included in ESMO guidelines as a local adjuvant to surgery/ curettageH
Benign tumours that usually develop in the long bones and tend to be small (< 1.5 cm); typically occur in children/adolescentsS
Incidence (per 100,00 per year): 0.1Q,R
Use of cryoablation:
Retrospective studies support use of CA for Tx of benign/ intermediate bone tumoursL,M,N
(Incidence of all benign bone tumour subtypes is ~ 2.6/ 100,000/year*)
- RFA already considered ‘gold-standard’ Tx
- Systemic review suggests CA may be a preferable option (improved safety near critical nerves and spinal chord, potential immunotherapy benefit)L
Closely related to osteoid osteoma, however, they are larger (> 1.5-2 cm) and more likely to affect the axial skeleton; usually present in young adultsS
Incidence (per 100,00 per year): <0.1Q,R
Use of cryoablation:
Retrospective studies support use of CA for Tx of benign/ intermediate bone tumoursL,M,N
(Incidence of all benign bone tumour subtypes is ~ 2.6/ 100,000/year*)
Blood-filled, fibrous, tumour-like cysts which most commonly appear in the vertebrae and knee; generally occur in young adultsV
Incidence (per 100,00 per year): 0.14T,U
Use of cryoablation:
Retrospective studies support use of CA for Tx of benign/ intermediate bone tumoursL,M,N
(Incidence of all benign bone tumour subtypes is ~ 2.6/ 100,000/year*)
- Cryotherapy considered as a local adjuvant to curettageW,Y
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
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
Defeat the pain with cryoablation – the MOTION study
92%
patients achieved pain palliation with reduced need for opioids
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
Our cryoablation solutions
We offer a broad portfolio of cryoablation systems and needles that provide an efficient treatment against tumours.
With game-changing innovation, we’ve streamlined our technology to meet the practical and efficiency demands of your minimally invasive procedures with no compromise to performance.
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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