Abstract No. 19 Optimal timing of cytotoxic chemotherapy when combined with thermal ablation of liver metastases

No. 18 Radiofrequency ablation in conjunction with vertebral augmentation for the treatment of spine metastases J. Stringam, A. Niekamp, J. Kuban, Z. Metwalli, S. Huang1, S. Chen, S. Yevich, R. Sheth; MD Anderson Cancer Center; Miami Vascular Purpose: To evaluate the safety and efficacy of radiofrequency ablation and cement augmentation for the treatment of secondary metastases to the spine Materials and Methods: This single-institution retrospective study evaluated the treatment of 332 lesions in 165 patients (94 men, mean age 64 years) over a 2-year period (2017 – 2019). Percutaneous radiofrequency ablation (RFA) and cement augmentation was performed under fluoroscopic or computed tomography guidance; kyphoplasty versus vertebroplasty was performed at the discretion of the provider. Treated levels included upper thoracic (39/332), lower thoracic (121/332), and lumbar (172/332) vertebral bodies. Results: The majority of treated levels (262/322, 81%) resulted in a substantial improvement in pain ( > 2-point reduction in Brief Pain Inventory scale following the procedure). Based on univariable and multivariable analysis, significant predictors of treatment failure included cancer type (melanoma, hematologic malignancies; P < 0.001), age > 70 years (P 1⁄4 0.03), and interventional imaging modality (fluoroscopy, P 1⁄4 0.01). Cement leakage occurred in 19% (61/322) of treated levels, though leakage was asymptomatic in all but 1 patient; posterior vertebral body wall erosion due to tumor was present in 19% (62/322) of treated levels and was not associated with leakage. However, use of RFAwas significantly associated with a decreased rate of leakage (P 1⁄4 0.003). No patients experienced spinal cord or spinal nerve injury following RFA. Conclusions: Radiofrequency ablation and cement augmentation is a safe and effective treatment for painful spinal metastasis. Scientific Session 4