Pain Palliation in Patients with Bone Metastases Using MR-Guided Focused Ultrasound Surgery: A Multicenter Study
Pain Palliation in Patients with Bone Metastases Using MR-Guided Focused Ultrasound Surgery: A Multicenter Study
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DOI：
10.1245/s10434-008-0011-2
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发表时间：
2009-01-01
影响因子：
3.7
通讯作者：
Catane, Raphael
中科院分区：
文献类型：
--
作者：
Liberman, Boaz;Gianfelice, David;Catane, Raphael
使用磁共振（MR）引导的聚焦超声（MRgFUS）的无创热消融已被证明在子宫肌瘤的临床有效性，并正在评估乳腺、肝脏和脑部病变的消融。最近，MRgFUS已被评价用于缓解骨转移引起的疼痛。本文介绍了一项多中心研究的临床结果，该研究旨在评价MRgFUS姑息治疗骨转移疼痛的安全性和有效性，对31例骨转移疼痛患者进行了MRgFUS治疗，这些患者均患有其他治疗无效或不可行的骨转移疼痛。通过评估器械相关并发症来评价治疗安全性。采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评价疼痛缓解的有效性。平均随访时间为4个月。25例患者接受了计划的治疗，并接受了3个月的治疗后随访。72%的患者（18/25）报告疼痛显著改善。平均VAS评分从治疗前的5.9降至治疗后3个月的1.8。67%有记录药物数据的患者报告阿片类药物使用减少。结果表明，MRgFUS能够为骨转移患者提供准确、有效、安全的无创姑息治疗。
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.