Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China; Department of Oncology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China.
Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China; Department of Oncology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China; Department of Oncology, Nanyang Second general Hospital, Nanyang, China.
Ann Palliat Med. 2021 Sep;10(9):9725-9731. doi: 10.21037/apm-21-2164.
Bone is among the most common metastasis sites in patients with advanced cancer. Approximately two-thirds of bone metastasis results in pain, the majority of which is moderate to unbearable pain, which seriously affects the quality of life of patients. With the development of ablation techniques, microwave ablation (MWA) has great potential to eliminate the pain caused by bone metastasis. This study aimed to evaluate the efficacy and safety of image-guided (computed tomography-guided) percutaneous MWA for metastatic osseous pain.
This is a retrospective study involving 18 patients with cancer-related pain caused by osseous or soft tissue metastasis in the First Affiliated Hospital of Soochow University from June 2015 to October 2020. All patients (14 men and 4 women; mean age 60.2 years) underwent image-guided percutaneous palliative MWA. A paired-sample t-test was used to compare the changes in Numeric Rating Scale (NRS) score and dosage of morphine preoperatively and postoperatively (at 24 h, 3 days, and 14 days after MWA). In addition, we assessed the level of pain relief according to the patients' subjective feelings.
The paired-samples t-test showed that the NRS score (6.83±0.92 vs. 1.67±0.97, P<0.05) and dosage of morphine (85.56±17.23 vs. 32.78±4.61, P<0.05) were significantly decreased at 3 days after MWA. At 14 days after MWA, the NRS score (6.83±0.92 vs. 0.94±0.87, P<0.05) and dosage of morphine (85.56±17.23 vs. 10.56±8.73, P<0.05) were also markedly decreased. Moreover, according to the patients' subjective feeling, 88.89% patients had pain relief postoperatively, while the remaining patients had no progress.
Image-guided (Computed Tomography-guided) percutaneous MWA can effectively relieve pain, thus improving the quality of life in patients with osseous metastasis. MWA is a feasible, safe, and effective treatment for pain caused by bone metastasis.
骨骼是晚期癌症患者最常见的转移部位之一。大约三分之二的骨转移导致疼痛，其中大多数为中到无法忍受的疼痛，严重影响了患者的生活质量。随着消融技术的发展，微波消融（MWA）在消除骨转移引起的疼痛方面具有巨大潜力。本研究旨在评估影像引导（计算机断层扫描引导）经皮 MWA 治疗转移性骨痛的疗效和安全性。
这是一项回顾性研究，纳入了 2015 年 6 月至 2020 年 10 月苏州大学第一附属医院收治的 18 例因骨或软组织转移导致癌性疼痛的患者。所有患者（男 14 例，女 4 例；平均年龄 60.2 岁）均接受影像引导下经皮姑息性 MWA 治疗。采用配对样本 t 检验比较术前和术后（MWA 后 24 小时、3 天和 14 天）NRS 评分和吗啡剂量的变化。此外，我们根据患者的主观感受评估疼痛缓解程度。
配对样本 t 检验显示，MWA 后 3 天，NRS 评分（6.83±0.92 比 1.67±0.97，P<0.05）和吗啡剂量（85.56±17.23 比 32.78±4.61，P<0.05）显著降低。MWA 后 14 天，NRS 评分（6.83±0.92 比 0.94±0.87，P<0.05）和吗啡剂量（85.56±17.23 比 10.56±8.73，P<0.05）也明显降低。此外，根据患者的主观感受，88.89%的患者术后疼痛缓解，其余患者无进展。
影像引导（计算机断层扫描引导）经皮 MWA 可有效缓解疼痛，从而提高骨转移患者的生活质量。MWA 是一种可行、安全、有效的治疗骨转移疼痛的方法。
