Efficacy of Radiofrequency Ablation in Pain Relief and Tumor Reduction in Multiple Myeloma Patients with Osteolytic Lesions

Sunday, March 30, 2025

3:27 PM – 3:36 PM CT

Location: Music City Center, 207 AB

Presenting Author(s)

PT

Pooya Torkian, MD

Integrated IR Resident
University of Minnesota, United States

Author/Co-author(s)

AP

Andrew Peterson, MD

Integrated IR Resident
University of Minnesota, United States
SW

Stephanie Wallace, MD

Medical student
University of minnesota, United States
Siobhan Flanagan, MD

Associate Professor
University of Minnesota, United States
PS

Prashant Shrestha, MD

Assistant Professor
University of Minnesota, United States
Reza Talaie, MD

Associate Professor
University of Minnesota, United States

Purpose: Effective pain management for multiple myeloma (MM) patients with osteolytic lesions remains a challenge. This study assesses the efficacy of radiofrequency ablation (RFA), an off-label use of the device, in providing pain relief and reducing tumor size.

Materials and Methods: A retrospective review of 20 MM patients with painful vertebral lesions who underwent RFA was conducted. Pain was measured using the Visual Analog Scale (VAS) at baseline and at 1, 3, 6, and 12 months. Functional status was assessed using the Oswestry Disability Index (ODI) and Karnofsky Performance Status (KPS). MRI and PET-CT were used to evaluate tumor reduction.

Results: RFA significantly reduced pain, with mean VAS scores decreasing from 8.2 (SD ±1.2) at baseline to 4.1 (SD ±2.3) at one month post-RFA (p < 0.005), sustained at 4.7 by twelve months. Functional outcomes improved markedly, with ODI scores decreasing by 46% (from 56.3 to 30.2, p < 0.005) and KPS scores increasing by 32% (from 60.5 to 80.0, p < 0.005) at six months. Imaging revealed a 51% decrease in lesion diameter (from 23.5 mm to 11.2 mm) and a 63% reduction in mean SUV Max (from 6.5 to 2.4). Complete metabolic responders (SUV Max reduction ≥70%) exhibited a significantly prolonged median progression-free survival (PFS) of 24.7 months compared to 9.2 months in partial responders (p < 0.05). Multivariate analysis identified lesion size reduction, SUV Max reduction, and ADC value as independent predictors of favorable outcomes. RFA was well-tolerated, with minimal complications in 10% of patients and no new fractures reported.

Conclusion: Radiofrequency ablation (RFA) effectively alleviates pain and reduces tumor burden in patients with multiple myeloma, as demonstrated by significant improvements in pain scores, functional status, and imaging response. These findings support RFA as a valuable intervention for managing osteolytic lesions in MM patients.