Focused ultrasound for the treatment of bone metastases: effectiveness and feasibility
Focused ultrasound for the treatment of bone metastases: effectiveness and feasibility
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DOI：
10.1186/s40349-018-0117-3
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发表时间：
2018-11-30
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影响因子：
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通讯作者：
Thyss, Antoine
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作者：
Bertrand, Anne-Sophie;Iannessi, Antoine;Thyss, Antoine
目的探讨高强度聚焦超声（HIFU）治疗骨转移瘤的有效性和可行性。方法采用单中心前瞻性研究方法，对17例有症状的骨转移瘤患者进行回顾性分析。患者在磁共振（MR）引导下接受聚焦超声（FU）治疗。接受FU的患者不适用于手术治疗或放疗。病变位于上颌骨和中轴骨，由继发性症状性病变组成。在治疗前、治疗后1周和1个月，使用视觉模拟量表（VAS）评估疼痛的临床过程，并记录口服吗啡等效日剂量（OMEDD）。我们使用Wilcoxon符号秩检验来评估患者疼痛的变化（R CRAN软件V3.1.1）。结果我们观察到患者在手术前和手术后1周之间（p = 2.9.10 - 4）以及手术前和手术后1个月之间（p = 3.10 - 4）的疼痛感显著降低。根据国际骨转移共识工作组的反应的比例是：部分反应50%（8/16）和完全反应37.5%（6/16）。结论HIFU下MR引导似乎是一种有效和安全的程序，在治疗有症状的骨病变的患者患有转移性疾病。观察到患者疼痛显著减轻。试验注册NCT 01091883。2010年3月24日注册。证据等级：3级。
BackgroundTo evaluate the effectiveness and feasibility of high-intensity focused ultrasound (HIFU) for the treatment of bone metastases. MethodsA single-center prospective study was made involving 17 consecutive patients with symptomatic bone metastases. Patients were treated by Focused Ultrasound (FUs) performed with magnetic resonance (MR) guidance. Surgical treatment or radiotherapy treatment was not indicated for patients who underwent FUs. Lesions were located in the appendicular and axial skeleton and consisted of secondary symptomatic lesions. The clinical course of pain was evaluated using the Visual Analog Scale (VAS) before treatment, at 1 week, and at 1 month after treatment and the Oral Morphine Equivalent Daily Dose (OMEDD) was also recorded. We used Wilcoxon signed rank test to assess change in patient pain (R CRAN software V 3.1.1).ResultsWe observed a significant decrease in the pain felt by patients between pre- procedure and 1 week post-procedure (p=2.9.10-4), and pre-procedure and 1 month post-procedure (p=3.10-4). The proportion of responders according to the International Bone Metastases Consensus Working Party was: Partial Response 50% (8/16) and Complete Response 37.5% (6/16).ConclusionsHIFU under MR-guidance seems to be an effective and safe procedure in the treatment of symptomatic bone lesions for patients suffering from metastatic disease. A significant decrease of patient pain was observed.Trial registrationNCT01091883. Registered 24 March 2010. Level of evidence: Level 3.