Significant palliation of spinal tumours with ablation system


Dfine has announced that two studies presented at the Society of Interventional Radiology’s (SIR) annual scientific meeting (13–18 April, New Orleans, USA) have underscored the benefits of targeted-radiofrequency ablation therapy (t-RFA) using Dfine’s Star tumour ablation system for the treatment of painful malignant lesions of the vertebral body. 

The first presentation—Image-guided t-RFA of spinal tumours using a novel bipolar navigational device: multicentre initial clinical experience”—by Jack Jennings (assistant professor of Radiology and director of Musculoskeletal and Spine Interventions at the Washington University School of Medicine at Washington University in St Louis, USA) noted that the Star system provided a significant clinical advantage by allowing access to spinal lesions that are not typically accessible with traditional ablative devices. In many cases, a company press release reported, this permitted treatment of individual lesions not controlled by systemic or radiation therapy.

In the study, Jennings and his co-authors treated 101 spinal lesions in 73 patients at six centres using the Star system, followed by cement augmentation with high-viscosity bone cement in those vertebrae with pathologic fractures. Lesion aetiology included a wide variety of metastatic tumours throughout the thoracolumbar and sacral spine. Cement augmentation post t-RFA proved to be efficient and resulted in predictable cement filling. Pain relief, measured by Visual Analogue Scale (VAS), was rapid, significant and durable measuring 7.35 pre-op, 2.47 at one week post-op, and 1.75 at six months post-op.

Decrease in pain medication usage was recorded post procedure and no complications or thermal injury were observed.

“The Star system is a highly effective tool capable of providing rapid pain relief from metastatic vertebral body tumours,” Jennings said. “We have found it to be particularly valuable when managing patients whose spinal tumours were unresponsive to traditional radiation and chemotherapy treatments. Now we can easily treat them using t-RFA without significant interruption to their primary cancer treatment regimen.”

In the second study, Robert Ryu, professor of Radiology of the Feinberg School of Medicine at Northwestern University and his co-authors used the Star system to treat 13 lesions in 11 patients that failed conventional chemotherapy and radiation therapy, followed by injection of high-viscosity bone cement into the ablated tumour bed. All patients noted clinically significant pain relief, with a decrease in average VAS score from 8.9 pre-procedure to 2.7 four days after treatment. No treatment-related complications occurred during the follow-up period. These data are consistent with the large multicentre experience (Jennings et al), demonstrating palliative treatment alternatives for painful spinal metastatic lesions.