Liberman Boaz, Gianfelice David, Inbar Yael, Beck Alexander, Rabin Tatiana, Shabshin Noga, Chander Gupta, Hengst Suzanne, Pfeffer Raphael, Chechick Aharon, Hanannel Arik, Dogadkin Osnat, Catane Raphael
Division of Orthopedics, Sheba Medical Center, Tel-Hashomer, Israel.
Ann Surg Oncol. 2009 Jan;16(1):140-6. doi: 10.1245/s10434-008-0011-2. Epub 2008 Nov 11.
Noninvasive thermal ablation using magnetic resonance (MR)-guided focused ultrasound (MRgFUS) has been shown to be clinically effective in uterine fibroids, and is being evaluated for ablation of breast, liver, and brain lesions. Recently MRgFUS has been evaluated for palliation of pain caused by bone metastases. We present the clinical results of a multicenter study using MRgFUS for palliation of bone metastases pain.
A multicenter study to evaluate the safety and efficacy of MRgFUS palliative treatment of bone metastases was conducted in patients suffering from painful metastatic bone lesions for which other treatments were either ineffective or not feasible. Thirty-one patients with painful bone metastases underwent the MRgFUS procedure in three medical centers. Treatment safety was evaluated by assessing the device-related complications. Effectiveness of pain palliation was evaluated using the visual analog pain score (VAS), and measurable changes in the intake of opioid analgesics.
Thirty-six procedures were performed on 31 patients. Mean follow-up time was 4 months. 25 patients underwent the planned treatment and were available for 3 months post-treatment follow-up. 72% of the patients (18/25) reported significant pain improvement. Average VAS score was reduced from 5.9 prior to treatment to 1.8 at 3 months post treatment. 67% of patients with recorded medication data reported a reduction in their opioid usage. No device-related severe adverse events were recorded.
The results suggest that MRgFUS has the ability to provide an accurate, effective, and safe noninvasive palliative treatment for patients with bone metastases.
磁共振（MR）引导聚焦超声（MRgFUS）的非侵入性热消融已被证明在子宫肌瘤治疗中具有临床疗效，目前正在对其用于乳腺、肝脏和脑部病变的消融进行评估。最近，MRgFUS已被用于评估缓解骨转移引起的疼痛。我们展示了一项使用MRgFUS缓解骨转移疼痛的多中心研究的临床结果。
对患有疼痛性转移性骨病变且其他治疗无效或不可行的患者进行了一项多中心研究，以评估MRgFUS姑息治疗骨转移的安全性和有效性。31例患有疼痛性骨转移的患者在三个医疗中心接受了MRgFUS治疗。通过评估与设备相关的并发症来评估治疗安全性。使用视觉模拟疼痛评分（VAS）和阿片类镇痛药摄入量的可测量变化来评估疼痛缓解的有效性。
对31例患者进行了36次治疗。平均随访时间为4个月。25例患者接受了计划治疗，并在治疗后3个月进行了随访。72%的患者（18/25）报告疼痛有显著改善。平均VAS评分从治疗前的5.9降至治疗后3个月的1.8。67%有用药记录数据的患者报告阿片类药物使用量减少。未记录与设备相关的严重不良事件。
结果表明，MRgFUS能够为骨转移患者提供准确、有效且安全的非侵入性姑息治疗。
