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Magnetic Resonance-Guided Focused Ultrasound Versus Conventional Radiation Therapy for Painful Bone Metastasis: A Matched-Pair Study

Lee, Hsin-Lun MD1,2; Kuo, Chia-Chun MD1; Tsai, Jo-Ting MD, PhD3; Chen, Chun-You MD4; Wu, Meng-Huang MD1; Chiou, Jeng-Fong MD, PhD1,a

Journal of Bone & Joint Surgery - American Volume: 20 September 2017 - Volume 99 - Issue 18 - p 1572–1578
doi: 10.2106/JBJS.16.01248
Scientific Articles
Disclosures

Background: Magnetic resonance-guided focused ultrasound (MRgFUS) is an alternative local therapy for patients with painful bone metastasis for whom standard conventional radiation therapy (RT) has failed. However, the therapeutic effects of MRgFUS as a first-line treatment for bone metastasis remain uncertain.

Methods: A matched-pair study was conducted to compare the therapeutic effects of MRgFUS with those of conventional RT as a first-line treatment for patients with painful bone metastasis. The MRgFUS and RT-treated groups were matched 1:2 by age, sex, primary cancer, pretreatment pain score, and treated site.

Results: According to the criteria for patient eligibility and matching, 21 and 42 patients (total, 63 patients) with bone metastasis treated with MRgFUS and conventional RT, respectively, were enrolled for analyses. The median ages of the MRgFUS and RT-treated patients were 59 and 61 years, respectively. Among the enrolled patients, 52% were male and 48% were female. The results showed that both MRgFUS and RT were effective. However, MRgFUS was more efficient than RT in terms of the time course of pain palliation as it yielded a significantly higher response rate at 1 week after treatment (71% versus 26%, p = 0.0009).

Conclusions: MRgFUS provides a similar overall treatment response rate but faster pain relief compared with conventional RT and has the potential to serve as the first-line treatment for painful bone metastasis in selected patients.

Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

1Departments of Radiation Oncology (H.-L.L. and J.-F.C.) and Orthopaedic Surgery (M.-H.W.), Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan

2The Ph.D. Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University and Academia Sinica, Taipei Medical University, Taipei, Taiwan

3Department of Radiation Oncology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan

4Department of Radiation Oncology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

E-mail address for J.-F. Chiou: sjfchiou@ms68.hinet.net

Copyright 2017 by The Journal of Bone and Joint Surgery, Incorporated
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