Clinical Effectiveness and Safety of Radiofrequency Ablation Combined with Percutaneous Osteoplasty in the Management of Pubic Skeletal Metastases.

Purpose: To evaluate the effectiveness and safety of combining radiofrequency (RF) ablation and percutaneous osteoplasty (POP) to relieve pain, enhance mobility, and improve the quality of life for patients with malignant pubic metastases.

Materials And Methods: A retrospective analysis was conducted on 29 patients with pain caused by pubic metastases who were treated between January 2014 and April 2024. All patients received RF ablation followed by POP, guided by biplane digital subtraction angiography (DSA) and performed under local anesthesia. The primary outcomes focused on pain reduction assessed by the visual analog scale (VAS), whereas the secondary outcomes included functional improvement evaluated by the Musculoskeletal Tumor Society (MSTS) system and quality of life measured using the Quality of Life Questionnaire-Bone Metastases 22 (QLQ-BM22). Procedure-related adverse events (AEs), survival rates, and Kaplan-Meier analysis were also evaluated during the follow-up period.

Results: All procedures were successfully completed without severe AEs. Significant improvements in VAS, MSTS, and QLQ-BM22 scores were observed postprocedurally (P < .001). Leakage of polymethylmethacrylate occurred in 9 cases (9/29, 31.0%); however, none required additional treatment. During the follow-up period, a total of 12 patients (12/29, 41.4%) died, with the median survival time of 48.0 months (SD ± 13.83).

Conclusions: The combination of RF ablation and POP is a feasible and effective treatment modality for pubic metastases, providing significant pain relief, improved limb function, and enhanced quality of life. This minimally invasive approach is a viable treatment option for patients with advanced cancer and has a low risk of AEs.