Cryoablation of bone, soft tissue, and nerve in the setting of uninterrupted systemic cancer therapies

Purpose

To assess safety of cryoablation in cancer patients receiving uninterrupted systemic cancer therapies with regard to wound healing.

Materials and methods

In this single-institution IRB-approved retrospective study, all patients (29/50 (58 %) female, mean age 61.9 +/− 11.3 years) undergoing cryoablation of bone, soft tissue, or nerve for symptomatic treatment while on uninterrupted systemic therapy between 2019 and 2022 were included for analysis. Charts were reviewed to identify post-cryoablation infection or wound healing complication within 90 days after cryoablation. All patients received routine prophylactic intraprocedural antibiotics; no patients were prescribed antibiotics post-procedure.

Results

Sixty-nine cryoablations of bone (42/69, 61 %), soft tissue (17/69, 25 %) and nerve (10/69,14 %) were performed without interrupting ongoing traditional chemotherapy, targeted therapy, immunotherapy, investigational clinical trial therapy, or hormone therapy in 32/69 (35 %), 26/69 (38 %), 14/69 (20 %), 5/69 (7 %) respectively. There were 3/69 (4 %) patients with neutropenia (defined as absolute neutrophil count <1500 cells/mL). Agents known to delay wound healing (such as VEGF/R, E/FGFR inhibitors) or chronic steroids were not interrupted in 9/69 (13 %) and 36/69 (52 %) respectively. Prior to cryoablation, the treatment zone was previously embolized in 8/69 (12 %) and irradiated in 34/69 (49 %). By mean clinical follow up of 41 days (range, 1–98 days post-cryoablation), no procedure-site infections nor wound healing complications occurred.

Conclusion

Wound healing abnormalities were not observed when performing percutaneous cryoablation with uninterrupted systemic therapies in this study, even in treatment zones that had received radiotherapy and embolization.