Radiofrequency ablation versus stereotactic body radiotherapy for painful osseous metastases: A comparative correlation meta-analysis of pain relief.

• DOI: 10.1200/jco.2020.38.15_suppl.e24156
• Publication Date: 2020-05-25T15:47:40Z
• Authors: Tej Mehta; Caleb Heiberger; Stephanie Kazi; Boggy Anton; Mark Brown; Matthew Lommen; Simcha Weissman; Divyajot Sandhu; Kelvin Hong; Douglas Yim; Minesh P. Mehta
• Keywords: Brief Pain Inventory

e24156 Background: Osseous metastases (OMs), a common cause of cancer pain, are only partially palliated by analgesics. Stereotactic body radiotherapy (SBRT) and radiofrequency ablation (RFA) increasingly used, but the comparative effectiveness SBRT vs. RFA for OMs has not been adequately evaluated. Herein we analyzed palliative benefits in terms pain relief from OMs. Methods: A systematic review was performed all studies reporting outcomes (defined as five or fewer fractions radiation) palliation Studies were excluded. Random effects model determined net Pearson correlation (R 2 ) post-SBRT post-RFA reduction over time. The pooled coefficient 95% confidence interval calculated using Fisher r-to- z transformation. Risk bias assessed sunset plots; heterogeneity I meta-regression. Results: Seven full-text articles total 1100 patients 22 557 patients. No directly compared to RFA. All included collected data on related OM disease pre- post-therapy. scales used visual analog scale (2 SBRT, 15 RFA), brief inventory (4 4 numeric rating (0 QLQ-15 (1 0 memorial index card 1 RFA). Mean dose 17.3 gy 2.6. Median follow-up 24 weeks 18 RFA, with median 59% =0.83, 95%CI:0.80-0.87, =58.63%) 64% =0.52, 95%CI:0.41-0.62, =48.16%) respectively. Meta-regression number metric fully accounted Sunset plots did indicate significant publication bias. Conclusions: published literature is predominately non-randomized, limiting evidence level. Pain durability comparable. Pre-SBRT therapies may obscure full effect either treatment modality. painful associated majority patients, this efficacy purpose inadequately reported literature. Future, combinatorial opposed single-modality approaches help increase overall well efficaciously palliating treatment-resistant