The study, which appears in the March 2005 issue of the American Journal of Roentgenology, found that cryoablation relieved the pain of four patients who had very advanced disease. The patients had various types of cancer that had spread to areas outside the abdomen organs, said Damian E. Dupuy, MD, professor of diagnostic imaging at Brown Medical School in Providence, RI. These patients were not candidates for surgery because the tumors were too close to critical structures or the patient had multi-focal disease. In addition, chemotherapy or radiation therapy had not been successful in controlling these areas of symptomatic disease.
Each patient underwent CT-guided percutaneous cryoablation. Cryoapplicators were inserted into the tumor area, and the tumor and adjacent areas were frozen. The freezing process kills cancer cells, small sensory nerves cells and inflammatory tissue, thus easing the patient's pain, Dr. Dupuy said. "We can watch the ice ball form on CT as it is being done to ensure the appropriate area is being treated," he said.
"This is generally an outpatient procedure, and all patients tolerated the procedure well," Dr. Dupuy said. One patient who had cancer in her brachial plexus did suffer some nerve damage in her arm. The patient had been told that nerve damage was a possibility, but she chose to have the procedure because she was in such extreme pain; she has regained some function, Dr. Dupuy said.
The patients had terminal cancer, and three of the four have died, Dr. Dupuy said. The one-time cryoablation treatment gave them pain relief up until the time of their death, he said.
This was a pilot study to determine how well this new technology can provide pain relief, said Dr. Dupuy. "We are beginning another study that will look at how well cryoablation can locally control large metastatic tumors unsuccessfully controlled with traditional therapies," he said.