Case Report Locoregional Treatment of Bone Metastasis in Lung Cancer Patient to Manage with Different Techniques: Electrochemotharapy, Crioablation and Cementoplasty
by Francesco Fiore1*, Salvatore Stilo1, Luca Tarotto1, Emanuela Federico2, Noemi Brignola2, Gaetano Sicuranza3, Roberto D’Angelo1, Valeria D’Alessio4, Roberta Fusco5
1Division of Interventional Radiology, Istituto Nazionale per lo studio e la cura dei Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy
2Division of Radiology, Università degli Studi di Napoli Federico II, Naples, Italy
3Division of Radiology, AOU Città della Salute Torino, Torino, Italy
4IGEA S.p.A., Clinical Biophysics Lab. Carpi, Modena, Italy.
5Division of Radiology, Istituto Nazionale per lo studio e la cura dei Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy
*Corresponding author: Francesco Fiore, Division of Interventional Radiology, Istituto Nazionale per lo studio e la cura dei Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy
Citation: Fiore F, Stilo S, tarotto L, Federico E, Brignola N, et al (2024) Locoregional Treatment of Bone Metastasis in Lung Cancer Patient to Manage with Different Techniques: Electrochemotharapy, Crioablation and Cementoplasty. Ann Case Report. 9: 2058. DOI:10.29011/2574-7754.102058
Received: 05 November 2024, Accepted: 11 November 2024, Published: 13 November 2024
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Abstract
Purpose: Bone metastases are common disabling complications in patients with cancer with high impact on general health status, quality life and survival. Many treatments are available for the palliative management of patients with metastatic bone disease including radiotherapy (RT), thermal and cryoablation, high intensity focused ultrasound, resection and the application of bone cement to fill osteolytic areas. Electro chemotherapy is a non thermal local treatment characterized by low invasiveness, rapidity and absence of severe adverse events.
Methods: a patient with radiotherapy resistant metastatic rib lesion from oligo-metastatic lung carcinoma was treated with Electro chemotherapy (ECT). Before ECT, he performed RT on the right femoral cox and on the 8th rib and afterwards cryoablation with cementoplasty of the hip and cryoplasty of the 8th rib. CT scan at 1 year, revealed a painful rib metastasis resistant to RT in another site. The patient was then treated percutaneously with Electro chemotherapy. The procedure was performed under general anesthesia + erector spinae plane (ESP) block. Under fluoroscopic guidance, in a sterile environment after local anesthesia, 12 needle-electrodes 18 G were positioned in a parallel course at the level of the deepest region of the aforementioned lesion. Eight minutes after the i.v. administration of Bleomycin 25 mg, reversible electroporation at 1000 V/cm is performed.
Results: CT scan at 3 months from the treatment showed a complete disappearance of the lesion. Electro chemotherapy of radiotherapy resistant metastatic rib lesion results in pain relief and disease resolution.
Conclusion: ECT is a good option when no other alternatives are possible to obtain tumor control and improvement in patient’s quality of life.
Keywords: Electrochemotherapy; Bone Metastases; Pain; Quality Of Life.
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