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Percutaneous cementoplasty in multiple myeloma: a valuable adjunct for pain control and ambulation maintenance

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Abstract

Goals of work

Bone pain and functional impairment are major concerns for multiple myeloma (MM) patients. The goal of this study was to better define the role of percutaneous cementoplasty (PC) in improving their quality of life.

Materials and methods

This retrospective analysis included 28 consecutive heavily pretreated MM patients managed at our institution between 1996 and 2002. They underwent a total of 34 PC procedures for the treatment of 117 vertebrae and 2 iliac sites and were evaluated at 1 month.

Main results

Significant pain reduction of >50% was obtained after 83% of the procedures, with a mean visual analogous score decreasing from 7.48/10 to 2.1/10 (p < 0.001). It resulted in a complete interruption of opiate analgesic consumption after 59.3% of the procedures, with a mean decrease of 70.4% in the opiate dose. Functional impairment was evaluated with the Eastern Cooperative Oncology Group (ECOG) performance status scale, with mean scores improving from 1.9 to 0.86 after the procedures (p = 0.001). There was no major complication.

Conclusion

PC is a safe, feasible, and efficient approach for the treatment of bone pain and disability in MM patients.

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References

  1. Barr JD, Barr MS, Lemley TJ, McCann RM (2000) Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine 25:923–928

    Article  PubMed  CAS  Google Scholar 

  2. Bartolozzi B, Nozzoli C, Pandolfo C, Antonioli E, Guizzardi G, Morichi R, Bosi A (2006) Percutaneous vertebroplasty and kyphoplasty in patients with multiple myeloma. Eur J Haematol 76:180–181

    Article  PubMed  Google Scholar 

  3. Cotten A, Dewatre F, Cortet B, Assaker R, Leblond D, Duquesnoy B, Chastanet P, Clarisse J (1996) Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical follow-up. Radiology 200:525–530

    PubMed  CAS  Google Scholar 

  4. Cotten A, Boutry N, Cortet B, Assaker R, Demondion X, Leblond D, Chastanet P, Duquesnoy B, Deramond H (1998) Percutaneous vertebroplasty: state of the art. Radiographics 18:311–320

    PubMed  CAS  Google Scholar 

  5. Diamond TH, Hartwell T, Clarke W, Manoharan A (2004) Percutaneous vertebroplasty for acute vertebral body fracture and deformity in multiple myeloma: a short report. Br J Haematol 124:485–487

    Article  PubMed  Google Scholar 

  6. Dudeney S, Lieberman IH, Reinhardt MK, Hussein M (2002) Kyphoplasty in the treatment of osteolytic vertebral compression fractures as a result of multiple myeloma. J Clin Oncol 20:2382–2387

    Article  PubMed  CAS  Google Scholar 

  7. Durie BG, Bataille R (1989) Therapeutic implications of myeloma staging. Eur J Haematol, Suppl 51:111–116

    CAS  Google Scholar 

  8. Durie BG, Kyle RA, Belch A, Bensinger W, Blade J, Boccadoro M, Child JA, Comenzo R, Djulbegovic B, Fantl D, Gahrton G, Harousseau JL, Hungria V, Joshua D, Ludwig H, Mehta J, Morales AR, Morgan G, Nouel A, Oken M, Powles R, Roodman D, San Miguel J, Shimizu K, Singhal S, Sirohi B, Sonneveld P, Tricot G, Van Ness B (2003) Myeloma management guidelines: a consensus report from the Scientific Advisors of the International Myeloma Foundation. Hematol J 4:379–398

    Article  PubMed  Google Scholar 

  9. Durr HR, Wegener B, Krodel A, Muller PE, Jansson V, Refior HJ (2002) Multiple myeloma: surgery of the spine: retrospective analysis of 27 patients. Spine 27:320–324

    Article  PubMed  Google Scholar 

  10. Evans AJ, Jensen ME, Kip KE, DeNardo AJ, Lawler GJ, Negin GA, Remley KB, Boutin SM, Dunnagan SA (2003) Vertebral compression fractures: pain reduction and improvement in functional mobility after percutaneous polymethylmethacrylate vertebroplasty retrospective report of 245 cases. Radiology 226:366–372

    Article  PubMed  Google Scholar 

  11. Fourney DR, Schomer DF, Nader R, Chlan-Fourney J, Suki D, Ahrar K, Rhines LD, Gokaslan ZL (2003) Percutaneous vertebroplasty and kyphoplasty for painful vertebral body fractures in cancer patients. J Neurosurg 98:21–30

    Article  PubMed  Google Scholar 

  12. Galibert P, Deramond H, Rosat P, Le Gars D (1987) Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie 33:166–168

    PubMed  CAS  Google Scholar 

  13. Grossman SA, Sheidler VR, Swedeen K, Mucenski J, Piantadosi S (1991) Correlation of patient and caregiver ratings of cancer pain. J Pain Sympt Manag 6:53–57

    Article  CAS  Google Scholar 

  14. Halpin RJ, Bendok BR, Liu JC (2004) Minimally invasive treatments for spinal metastases: vertebroplasty, kyphoplasty, and radiofrequency ablation. J Support Oncol 2:339–351

    PubMed  Google Scholar 

  15. Hentschel SJ, Rhines LD, Shah HN, Burton AW, Mendel E (2004) Percutaneous vertebroplasty in vertebra plana secondary to metastasis. J Spinal Disord Tech 17:554–557

    Article  PubMed  Google Scholar 

  16. Hoskin PJ (2003) Bisphosphonates and radiation therapy for palliation of metastatic bone disease. Cancer Treat Rev 29:321–327

    Article  PubMed  CAS  Google Scholar 

  17. Kallmes DF, Jensen ME (2003) Percutaneous vertebroplasty. Radiology 229:27–36

    Article  PubMed  Google Scholar 

  18. Kaufmann TJ, Jensen ME, Schweickert PA, Marx WF, Kallmes DF (2001) Age of fracture and clinical outcomes of percutaneous vertebroplasty. Am J Neuroradiol 22:1860–1863

    PubMed  CAS  Google Scholar 

  19. Kelekis A, Lovblad KO, Mehdizade A, Somon T, Yilmaz H, Wetzel SG, Seium Y, Dietrich PY, Rufenacht DA, Martin JB (2005) Pelvic osteoplasty in osteolytic metastases: technical approach under fluoroscopic guidance and early clinical results. J Vasc Interv Radiol 16:81–88

    PubMed  Google Scholar 

  20. Kim AK, Jensen ME, Dion JE, Schweickert PA, Kaufmann TJ, Kallmes DF (2002) Unilateral transpedicular percutaneous vertebroplasty: initial experience. Radiology 222:737–741

    Article  PubMed  Google Scholar 

  21. Martin JB, Jean B, Sugiu K, San Millan RD, Piotin M, Murphy K, Rufenacht B, Muster M, Rufenacht DA (1999) Vertebroplasty: clinical experience and follow-up results. Bone 25:11S–15S

    Article  PubMed  CAS  Google Scholar 

  22. Martin JB, Wetzel SG, Seium Y, Dietrich PY, Somon T, Gailloud P, Payer M, Kelekis A, Ruefenacht DA (2003) Percutaneous vertebroplasty in metastatic disease: transpedicular access and treatment of lysed pedicles—initial experience. Radiology 229:593–597

    Article  PubMed  Google Scholar 

  23. Peh WC, Gilula LA (2003) Percutaneous vertebroplasty: indications, contraindications, and technique. Br J Radiol 76:69–75

    Article  PubMed  CAS  Google Scholar 

  24. Ramos L, Las Heras JA, Sanchez S, Gonzalez-Porras JR, Gonzalez R, Mateos MV, San Miguel JF (2006) Medium-term results of percutaneous vertebroplasty in multiple myeloma. Eur J Haematol 77:7–13

    Article  PubMed  Google Scholar 

  25. Roila F, Lupattelli M, Sassi M, Basurto C, Bracarda S, Picciafuoco M, Boschetti E, Milella G, Ballatori E, Tonato M (1991) Intra and interobserver variability in cancer patients’ performance status assessed according to Karnofsky and ECOG scales. Ann Oncol 2:437–439

    PubMed  CAS  Google Scholar 

  26. San Millan RD, Burkhardt K, Jean B, Muster M, Martin JB, Bouvier J, Fasel JH, Rufenacht DA, Kurt AM (1999) Pathology findings with acrylic implants. Bone 25:85S–90S

    Article  Google Scholar 

  27. Shimony JS, Gilula LA, Zeller AJ, Brown DB (2004) Percutaneous vertebroplasty for malignant compression fractures with epidural involvement. Radiology 232:846–853

    Article  PubMed  Google Scholar 

  28. Stallmeyer MJ, Zoarski GH, Obuchowski AM (2003) Optimizing patient selection in percutaneous vertebroplasty. J Vasc Interv Radiol 14:683–696

    PubMed  Google Scholar 

  29. Taylor AE, Olver IN, Sivanthan T, Chi M, Purnell C (1999) Observer error in grading performance status in cancer patients. Support Care Cancer 7:332–335

    Article  PubMed  CAS  Google Scholar 

  30. Walker MP, Yaszemski MJ, Kim CW, Talac R, Currier BL (2003) Metastatic disease of the spine: evaluation and treatment. Clin Orthop Relat Res S165–S175

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Authors and Affiliations

  1. Division of Oncology, Geneva University Hospital, 21 rue Micheli-du-Crest, 1211, Geneva 14, Switzerland

    Nhu Nam Tran Thang, Yodit Seium-Neberay, Marie-Christine Verbist, Andre-Pascal Sappino & Pierre-Yves Dietrich

  2. Department of Radiology, Geneva University Hospital, 21 rue Micheli-du-Crest, 1211, Geneva 14, Switzerland

    German Abdo, Jean-Baptiste Martin, Hasan Yilmaz & Daniel Rufenacht

Authors
  1. Nhu Nam Tran Thang
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  2. German Abdo
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  3. Jean-Baptiste Martin
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  4. Yodit Seium-Neberay
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  5. Hasan Yilmaz
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  6. Marie-Christine Verbist
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  7. Daniel Rufenacht
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  8. Andre-Pascal Sappino
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  9. Pierre-Yves Dietrich
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Correspondence to Pierre-Yves Dietrich.

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Tran Thang, N.N., Abdo, G., Martin, JB. et al. Percutaneous cementoplasty in multiple myeloma: a valuable adjunct for pain control and ambulation maintenance. Support Care Cancer 16, 891–896 (2008). https://doi.org/10.1007/s00520-007-0344-6

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  • DOI: https://doi.org/10.1007/s00520-007-0344-6

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