Matsumoto Tomohiro, Yoshimatsu Rika, Osaki Marina, Shibata Junki, Maeda Hitomi, Miyatake Kana, Noda Yoshinori, Yamanishi Tomoaki, Yamagami Takuji
Department of Diagnostic and Interventional Radiology, Kochi Medical School, Kochi University, Oko-cho, Kohasu, Nankoku, Kochi, 783-8505, Japan.
Department of Radiology, Kochi Health Sciences Center, 2125-1 Ike, Kochi, 781-0111, Japan.
Int J Clin Oncol. 2024 Apr;29(4):372-385. doi: 10.1007/s10147-023-02458-z. Epub 2024 Jan 13.
To conduct a systematic review and meta-analysis of publications to evaluate the analgesic efficacy and safety of percutaneous thermal ablation (PTA) plus percutaneous cementoplasty (PCP) (PTA + PCP) for painful bone metastases.
We searched PubMed, Cochrane Library and Embase for articles published up to October 2022. Outcomes were a 10-point pain scale, morphine equivalents daily dose (MEDD) and complications. A subgroup confined to spinal bone metastases was analyzed.
Twenty-one articles were selected for the analysis. The 21 selected articles involved a total of 661 cases. The pooled pain scales at pre-PTA + PCP, 1 day, 1 week and 1-, 3-, and 6 months post-PTA + PCP were 7.60 (95% confidence interval [CI], 7.26-7.95, I = 89%), 3.30 (95% CI, 2.25-4.82, I = 98%), 2.58 (95% CI, 1.99-3.35, I = 94%), 2.02 (95% CI, 1.50-2.71, I = 93%), 1.78 (95% CI, 1.26-2.53, I = 95%), and 1.62 (95% CI, 1.14-2.31, I = 88%), and in the subgroup, 7.97 (95% CI, 7.45-8.52, I = 86%), 3.01 (95% CI, 1.43-6.33, I = 98%), 2.95 (95% CI, 1.93-4.51, I = 95%), 2.34 (95% CI, 1.82-3.01, I = 68%), 2.18 (95% CI, 1.57-3.03, I = 78%), and 2.01 (95% CI, 1.16-3.48, I = 86%). Mean MEDD decreased up to 3 months post-PTA + PCP in 4 articles. The overall pooled major complication rate was 4% (95% CI, 2-6%, I = 2%).
The updated systematic review and meta-analysis indicates that PTA + PCP for painful bone metastases is safe, and can lead to rapid and sustained pain reduction.
对相关出版物进行系统评价和荟萃分析，以评估经皮热消融（PTA）联合经皮骨水泥成形术（PCP）（PTA+PCP）治疗疼痛性骨转移瘤的镇痛疗效和安全性。
检索截至2022年10月发表在PubMed、Cochrane图书馆和Embase上的文章。观察指标为10分制疼痛评分、每日吗啡等效剂量（MEDD）和并发症。对局限于脊柱骨转移瘤的亚组进行分析。
选取21篇文章进行分析。入选的21篇文章共涉及661例病例。PTA+PCP术前、术后1天、1周以及术后1、3和6个月的合并疼痛评分分别为7.60（95%置信区间[CI]，7.26-7.95，I=89%）、3.30（95%CI，2.25-4.82，I=98%）、2.58（95%CI，1.99-3.35，I=94%）、2.02（95%CI，1.50-2.71，I=93%）、1.78（95%CI，1.26-2.53，I=95%）和1.62（95%CI，1.14-2.31，I=88%），在亚组中分别为7.97（95%CI，7.45-8.52，I=86%）、3.01（95%CI，1.43-6.33，I=98%）、2.95（95%CI，1.93-4.51，I=95%）、2.34（95%CI，1.82-3.01，I=68%）、2.18（95%CI，1.57-3.03，I=78%）和2.01（95%CI，1.16-3.48，I=86%）。4篇文章中，PTA+PCP术后3个月内平均MEDD下降。总体合并严重并发症发生率为4%（95%CI，2-6%，I=2%）。
更新的系统评价和荟萃分析表明，PTA+PCP治疗疼痛性骨转移瘤是安全的，且能迅速且持续地减轻疼痛。
