A.V. Bukharov1, M.D. Aliev2, V.A. Derzhavin3, D.O. Elkhov4, D.A. Erin5, A.D. Kaprin6

1,3–6 Moscow P.A. Hertzen Cancer Research Center – branch of National Medical Research Center of Radiology
 (Moscow, Russia)
2,6 National Medical Research Radiological Centre (Obninsk, Russia)
 6 RUDN University, (Moscow, Russia)
 1artembuharov@mail.ru, 2oncology@inbox.ru, 3 aeon95@yandex.ru, 4 osteosa@yandex.ru, 5 erindmal@yandex.ru, 6 kaprin@mail.ru

Metastatic bone disease is the most common cause of chronic pain in cancer patients. Approximately one third of patients with bone metastases are diagnosed with pathological fractures, which ultimately leads to a sharp deterioration in the quality of life of patients. Interventional techniques for the treatment of bone destruction in cancer patients can significantly improve the quality of life of patients without resorting to extensive surgical interventions. P.A. Hertzen Moscow Oncology Research Institute from 2013 to 2022 1005 minimally invasive surgical interventions, such as vertebroplasty (VP) (n = 772), osteoplasty (OP) (n = 102), and radiofrequency thermal ablation (RTA) (n = 130), were performed in 520 patients for bone tumors. The average age is 49 years. Most often, minimally invasive treatments were performed in patients with breast cancer metastases — 237 (45.5%) and in kidney cancer metastases in 52 (10%). RTA was performed in the presence of an extraosseous soft tissue component of the tumor. In 70 patients, 85 RTA of bone tumors were performed in combination with subsequent VP (30) or OP (55), since the lesions were localized in the bones bearing the axial load. All patients were activated 1–12 hours after the manipulations. Positive dynamics of pain syndrome according to the visual analogue scale was observed in 458 (88%) patients, according to the Watkins scale in 426 (82%), according to the Karnofsky scale, the quality of life improved in 354 (68%). Multilevel vertebroplasty (from 6 to 15 vertebrae) was performed in 30 (6%) patients with multiple metastatic lesions and diffuse pain in the spine. Complications in the form of polymethyl methacrylate interposition into soft tissues and/or into the spinal canal were observed in 50 (15%) patients, of which clinically manifested complications were observed in 7 (1.5%) patients. Burns of the skin and subcutaneous adipose tissue in the area of RTA were observed in two (2%) patients. The average duration of hospitalization is 3 bed-days.Minimally invasive methods in the treatment of patients with metastatic lesions of the skeletal system can significantly reduce the intensity of pain syndrome, the risk of pathological fracture, increase the motor activity of patients and thereby significantly improve their quality of life without affecting the timing of special therapy.

Bukharov A.V., Aliev M.D., Derzhavin V.A., Elkhov D.O., Erin D.A., Kaprin A.D. Surgical minimally invasive and interventional methods in metastatic bone lesions. Biomedicine Radioengineering. 2023. V. 26. № 6. P. 17–24. DOI: https://doi.org/10.18127/ j15604136-202306-03 (In Russian)

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