The Safety And Efficacy Of The Magnetic Resonance Guided Focused Ultrasound Surgery For Treating Painful Bone Metastases

Objective:To evaluate the safety and efficacy of magnetic resonance guided focus ultrasound surgery(MRgFUS)in treatment for pain palliation of bone metastases.Methods:81 patients of painful bone metastases were volunteered to screen for this study in Shanghai General Hospital from June 2014 to September 2015.35 patients among them were treated by MRgFUS,who was more than 18-years old,having the ability to fully understand the informed consent of the research,suffering with pain of numeric rating scale(NRS)≥4,non-received radiotherapy or chemotherapy for pain palliation of bone metastases in the past two weeks.The NRS,the standard question of Brief Pain Inventory(BPI-QoL),and the standard question of Europe Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Bone Metastases22(EORTC QLQ-BM22)were respectively recorded before and 1-week,1-month,3-month after the treatment.The related adverse events of MRgFUS were observed and recorded in 3 months after the treatment as well.Results:1.35 metastatic bone tumor lesions of 35 patients were treated by MRgFUS,the treatment data was as follows: the mean treatment time was(83.94±27.87)minutes,the mean sonication number was 12.74±7.30.2.The NRS of before treatment and at 1-week,1-month,and 3-month after treatment respectively was 6.17±1.68,4.31±2.33,3.75±2.41,and 3.10±2.23 which significantly decreased after the treatment(P<0.01).3.The BPI-QoL score of before treatment and at 1-week,1-month,and 3-month after treatment respectively was 38.40±15.64,29.94±18.37,28.52±19.22,and 22.75±18.56,which significantly decreased after the treatment(P<0.001).4.The EORTC QLQ-BM22 score of before treatment and at 1-week,1-month,and 3-month after treatment respectively was 51.13±13.26,42.56±11.91,41.26±12.27,38.32±11.80,which also significantly decreased after the treatment(P<0.001).Conclusions MRgFUS can be used as a non-invasive,safe,and effective method for treating painful bone metastases.Its clinical benefits of pain palliation and patient’s quality of life improving are sustained after the treatment at least to 3 months.5.Adverse events included: pain in therapy area(3/35),which spontaneous relieving within one week;numbness in lower limb(1/35),which relieved after physiotherapy.