Department of Oncology, Tengzhou Central People's Hospital Affiliated to Jining Medical College, Tengzhou, Shandong Province, China.
Department of Oncology, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong, China.
J Vasc Interv Radiol. 2021 Jun;32(6):861-868. doi: 10.1016/j.jvir.2021.03.523. Epub 2021 Mar 23.
To evaluate the efficacy and safety of combined microwave ablation (MWA) and osteoplasty as a palliative therapy for painful bone metastases.
As an extension of a previous limited single-center study, a retrospective review was conducted for 147 patients (77 male, 70 female) with painful bone metastases who underwent MWA combined with osteoplasty. In total, 102 (69.4%), 41 (27.9%), and 4 (2.7%) patients had spinal metastases, extraspinal metastases, and both, respectively. Treatment efficacy was determined by comparing visual analog scale (VAS) scores, daily morphine equivalent opioid consumption, and Oswestry disability index (ODI) scores before treatment and during the follow-up period (mean follow-up, 9.8 months; range 3-16).
The mean VAS score significantly declined from 6.4 ± 2.3 before treatment to 3.2 ± 2.1, 1.9 ± 1.6, 1.8 ± 1.6, 1.8 ± 1.6, and 1.9 ± 1.6 at 24 hours, 1 week, 4 weeks, 12 weeks, and 24 weeks after treatment, respectively (P < .01). Furthermore, the mean daily morphine equivalent opioid consumption was significantly reduced from 81.5 ± 32.8 mg before treatment to 40.0 ± 20.6, 32.4 ± 10.2, 26.4 ± 10.0, 21.5 ± 8.3, and 19.3 ± 7.4 mg. The mean ODI score also declined after treatment (P < .0001). Major complications occurred in 4 of 147 patients, with 1 pathologic fracture, 1 nerve injury, and 2 mild skin infections. Minor cement leakages were observed at 69 sites (32.8%).
MWA combined with osteoplasty is an effective and safe treatment for painful bone metastases.
评估微波消融（MWA）联合骨成形术作为治疗骨转移痛的姑息性治疗的疗效和安全性。
作为之前有限的单中心研究的扩展，对 147 例（77 例男性，70 例女性）接受 MWA 联合骨成形术治疗的骨转移痛患者进行了回顾性分析。其中，分别有 102 例（69.4%）、41 例（27.9%）和 4 例（2.7%）患者有脊柱转移、脊柱外转移和两者均有转移。通过比较治疗前后的视觉模拟量表（VAS）评分、每日吗啡等效阿片类药物消耗量和 Oswestry 残疾指数（ODI）评分来评估治疗效果（平均随访 9.8 个月；范围 3-16 个月）。
治疗前患者的 VAS 评分为 6.4 ± 2.3，治疗后 24 小时、1 周、4 周、12 周和 24 周时分别降至 3.2 ± 2.1、1.9 ± 1.6、1.8 ± 1.6、1.8 ± 1.6 和 1.9 ± 1.6（P<.01）。此外，治疗前患者每日吗啡等效阿片类药物消耗量为 81.5 ± 32.8mg，治疗后 40.0 ± 20.6、32.4 ± 10.2、26.4 ± 10.0、21.5 ± 8.3 和 19.3 ± 7.4mg（P<.01）。治疗后患者的 ODI 评分也下降（P<.0001）。147 例患者中有 4 例出现主要并发症，包括 1 例病理性骨折、1 例神经损伤和 2 例轻度皮肤感染。69 处（32.8%）可见轻微的骨水泥渗漏。
MWA 联合骨成形术是治疗骨转移痛的一种有效且安全的治疗方法。
