**6.7 Thermal ablation**

For patients who have persistent or recurrent pain due to one or a few skeletal sites with small volume disease after palliative radiation therapy, and who are not candidates for surgery or reirradiation, local thermal ablation is an important therapeutic option. Radiofrequency ablation, microwave ablation, and cryoablation are effective ablative treatments for the palliation of symptomatic skeletal metastases [45–48]. There are no randomized trials comparing these procedures, so the choice of ablation technique should take into account availability, patient preference, and local expertise.
