Metastatic bone disease ablation and augmentation for local tumour control: a narrative review

Interventional oncology has gained a lot of traction as an attractive alternative treatment for various musculoskeletal tumours by offering minimally invasive image-guided therapies. In this domain, thermal ablation is increasingly being used malignant tumours, including bone metastatic disease. Thermal ablation therapies such as radiofrequency ablation, microwave ablation, cryoablation and high intensity focused ultrasound therapy achieve excellent local tumour control and pain palliation, whilst structural stability is ensured through the combination with bone augmentation techniques such as standard or reinforced osteoplasty. Many factors are affecting the results including the biology of the disease the treatment intent (curative or palliative) as well as the potential for complications, like thermal injury to surrounding tissues, highlight the need for meticulous procedural planning. This review highlights the pathophysiology, the current repertoire of thermal ablation techniques, clinical outcomes and the future directions for the treatment of metastatic bone disease.