Gu Jianjun, Wang Han, Tang Na, Hua Yingqi, Yang Haiyan, Qiu Yimin, Ge Renbin, Zhou Ying, Wang Wenwen, Zhang Guixiang
Department of Radiology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, China.
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Zhonghua Yi Xue Za Zhi. 2015 Nov 3;95(41):3328-32.
To evaluate the safety and efficacy of magnetic resonance guided focused ultrasound surgery (MRgFUS) in treatment for pain palliation of bone metastases.
Eighty-one patients of painful bone metastases were volunteered to screen for this study in Shanghai General Hospital from June 2014 to February 2015. Twenty-three patients among them were treated by MRgFUS, who was more than 18-years old, having the ability to fully understand the informed consent of the research, suffering with pain of numeric rating scale (NRS) ≥ 4, non-received radiotherapy or chemotherapy for pain palliation of bone metastases in the past two weeks. The NRS, the standard question of Brief Pain Inventory (BPI-QoL), and the standard question of Europe Organization for Research and Treatment of Cancer Quality of Life Questionnaire- Bone Metastases 22 (EORTC QLQ-BM22) were respectively recorded before and 1-week, 1-month, 3-month after the treatment. The related adverse events of MRgFUS were observed and recorded in 3 months after the treatment as well.
(1)Twenty-three metastatic bone tumor lesions of 23 patients were treated by MRgFUS, the treatment data was as follows: the mean treatment time was (88 ± 33) minutes, the mean sonication number was 13 ± 8. (2) Adverse events included: pain in therapy area 3/23, which spontaneous relieving within one week; numbness in lower limb (1/23), which relieved after physiotherapy. (3) The NRS of before treatment and at 1-week, 1-month, and 3-month after treatment respectively was 6.0 ± 1.5, 3.7 ± 1.7,3.1 ± 2.0, and 2.2 ± 1.0,which significantly decreased after the treatment (P<0.01). (4) The BPI-QoL score of before treatment and at 1-week, 1-month, and 3-month after treatment respectively was 39 ± 16, 27 ± 18, 26 ± 18, and 21 ± 18, which significantly decreased after the treatment (P<0.01). (5) The EORTC QLQ-BM22 score of before treatment and at 1-week, 1-month, and 3-month after treatment respectively was 52 ± 13, 44 ± 12, 42 ± 12, and 39 ± 12, which also significantly decreased after the treatment (P<0.01).
MRgFUS can be used as a non-invasive, safe, and effective method for treating painful bone metastases. Its clinical benefits of pain palliation and patient's quality of life improving are sustained after the treatment at least to 3 months.
评估磁共振引导聚焦超声手术（MRgFUS）治疗骨转移瘤疼痛缓解的安全性和有效性。
2014年6月至2015年2月，81例骨转移瘤疼痛患者自愿参与本研究，在上海交通大学医学院附属瑞金医院进行筛选。其中23例患者接受MRgFUS治疗，年龄均大于18岁，能充分理解研究知情同意书内容，数字评分法（NRS）评分≥4，近2周内未接受过骨转移瘤疼痛缓解的放疗或化疗。分别记录治疗前及治疗后1周、1个月、3个月的NRS、简明疼痛量表（BPI-QoL）标准问题、欧洲癌症研究与治疗组织生活质量问卷-骨转移22（EORTC QLQ-BM22）标准问题。治疗后3个月内观察并记录MRgFUS相关不良事件。
（1）23例患者的23个转移性骨肿瘤病灶接受MRgFUS治疗，治疗数据如下：平均治疗时间为（88±33）分钟，平均超声照射次数为13±8次。（2）不良事件包括：治疗区域疼痛3/23，1周内自行缓解；下肢麻木1/23，经理疗后缓解。（3）治疗前及治疗后1周、1个月、3个月的NRS分别为6.0±1.5、3.7±1.7、3.1±2.0、2.2±1.0，治疗后显著降低（P<0.01）。（4）治疗前及治疗后1周、1个月、3个月的BPI-QoL评分分别为39±16、27±18、26±18、21±18，治疗后显著降低（P<0.01）。（5）治疗前及治疗后1周、1个月、3个月的EORTC QLQ-BM22评分分别为52±13、44±12、42±12、39±12，治疗后也显著降低（P<0.01）。
MRgFUS可作为一种非侵入性、安全有效的方法治疗骨转移瘤疼痛。其在缓解疼痛和改善患者生活质量方面的临床益处至少可持续至治疗后3个月。
