CT-guided radiofrequency ablation and percutaneous cementoplasty in the treatment of bone metastases: a single-center experience

Abstract Computed chromography-Guided radiofrequency ablation (RFA) combined with percutaneous cementoplasty (PC) has emerged as a promising minimally invasive strategy for managing bone metastases. The present study was designed to evaluate the clinical benefits and safety of this combined approach. A retrospective analysis was conducted on data from 69 patients harboring 127 bone metastases who received RFA combined with PC between January 2023 and June 2023. Treatment outcomes were assessed using the Quality of Life Questionnaire-Bone Metastases 22 (QLQ-BM22), and the incidence of complications was documented to evaluate procedural safety. Logistic regression analysis was employed to determine risk factors for local tumor control. All procedures were completed successfully without major complications, yielding a technical success rate of 100%. The local tumor control rate at 3 months was 86.61% (110/127), and asymptomatic bone cement leakage was noted in 47.8% (33/69) of patients. Multivariate regression analysis identified trabecular bone score (odds ratio [OR] = 0.001, P = 0.031), prior radiation therapy (OR = 13.934, P = 0.001), metastasis location (OR = 4.090, P = 0.041), and ablation power (OR = 1.232, P = 0.003) as independent predictors of treatment outcome. Mean QLQ-BM22 scores for painful sites and pain characteristics showed significant reductions at one week after treatment ( P < 0.05), while functional interference and psychosocial aspects demonstrated significant improvement at one month ( P < 0.05). These findings indicate that RFA combined with PC is a safe and effective approach for bone metastases, providing meaningful pain relief, enhanced quality of life, and delayed tumor progression. Graphical Abstract