Abstract:ObjectiveTo investigate the clinical efficacy and safety of cryoablation combined with zoledronic acid sequential therapy for bone metastases pain.MethodsTwentyfour patients from our department suffering from malignant tumors with moderate to severe pain due to bone metastases were enrolled in this study. Those patients with 28 metastatic bone tumors were successfully treated with cryoablation operations under CTguided. Three days after cryoablation they were offered zoledronic acid (4 mg added in 100 ml normal saline, dripping for more than 15 min), once 4 weeks. Pain level and life quality were respectively evaluated by NRS (Numerical rating scale) and KPS (Karnofsky performance status), before cryoablation, 3 days after cryoablation, 2 weeks and 12 weeks after zoledronic acid sequential therapy.ResultsWithout serious complications, all of 24 patients were successfully punctured to tumor lesions. Patients’ pain scores were 7.70±0.86 (before cryoablation), 3.29±0.95 (3 d after cryoablation), 2.54±0.83 (2 weeks after zoledronic acid sequential therapy) and 2.17±0.76 (12 weeks after zoledronic acid sequential therapy)，with a significant statistical difference between pretherapy and posttreatment (F=530.64, P<0.001); during observation period after treatment, the effective rate in pain was 91.67%. KPS scores were 45.83±6.54 (before cryoablation), 49.58±6.24 (3 d after cryoablation), 61.67±7.01 (2 weeks after zoledronic acid sequential therapy) and 78.33±8.68 (12 weeks after zoledronic acid sequential therapy), with a significant statistical difference between pretherapy and posttreatment (F=418.99, P<0.001); during observation period after treatment, the effective rate in KPS was 75.00%. Six months after the treatment, there were 10 cases of CR, 11 cases of PR, and the effective rate was 87.50%.ConclusionCryoablation combined with zoledronic acid may be an effective therapeutic method with good safety in the treatment of patients with bone metastases pain.

Key words:Cryosurgery,Neoplasm metastases,Pain,Bisphosphonates