【摘要】 目的评价MR导引聚焦超声术(MRg FUS)姑息性治疗其它治疗手段无效或不可行的骨转移瘤疼痛患者近期效果和安全性。方法对21例症状性骨转移患者进行前瞻性研究。根据术后3个月内手术相关并发症发生率和严重程度评估治疗安全性。根据疼痛数字评价量表(NRS)评分、简明疼痛问卷-生存质量量表(BPI-QOL)评分、Karnofsky行为状态评分(KPS)和患者用药变化评价疼痛缓解效果。结果 21例症状性骨转移患者完成MRg FUS治疗。术前1周,术后1周、1个月、2个月、3个月NRS评分分别为7.7±1.6、3.6±2.6、3.9±3.2、4.3±3.3、3.7±2.7,术后各随访时间点NRS评分均显著下降,与术前评分差异均有统计学意义(P<0.05)。BPI-QOL评分术前1周(27.3±20.9)与术后1周(34.1±15.5)、1个月(32.3±19.2)、2个月(31.9±18.9)、3个月(28.8±14.8)间差异均无统计学意义(P值分别为0.24、0.45、0.48、0.81)。KPS评分术前1周(82.2±8.8)与术后1周(84.8±7.5)、3个月(84.8±7.5)间差异均无统计学意义(P值分别为0.64、0.33)。结论 MRg FUS姑息性治疗骨转移疼痛近期效果确切,技术安全,有望成为骨转移疼痛治疗的一种有前途的替代手段。更多还原

【Abstract】 Objective To evaluate the short-term efficacy and safety of magnetic resonance-guided focused ultrasound surgery(MRgFUS), as a palliative therapy, in relieving pain, which is ineffective to other treatments or which is not suitable for other treatments, in patients with bone metastases. Methods Twentyone patients with symptomatic bone metastases were recruited in this prospective study. Treatment safety was assessed by evaluating the incidence and severity of device-related complications within 3 months after treatment. The effectiveness of pain palliation was evaluated by the numerical rating scale(NRS), the brief pain inventory-quality of life(BPI-QOL), the Karnofsky performance status scale(KPS), and the changes of drug use in patients. Results Twenty-patients suffering from symptomatic bone metastases successfully underwent MRgFUS procedure. NRS scores determined before treatment and one week, one month, 2 months and 3 months after treatment were 7.7 ±1.6、3.6±2.6、3.9±3.2、4.3±3.3 and 3.7±2.7 respectively. NRS score was significantly decreased at each follow-up time point after treatment, which was significantly different from the preoperative NRS score(P<0.05). BPI-QOL scores determined before treatment and one week, one month, 2 months and 3 months after treatment were 27.3 ±20.9, 34.1 ±15.5, 32.3 ±19.2, 31.9 ±18.9 and 28.8 ±14.8 respectively, the differences between the preoperative score and the postoperative ones were not statistically significant(P=0.24, P=0.45, P=0.48 and P=0.81 respectively). The preoperative KPS score was 82.2±8.78,and the one week and 3 months postoperative KPS scores were 84.8±7.5 and 84.8±7.5 respectively, and no statistically significant differences existed between the preoperative score and postoperative ones(P=0.64 and P =0.33 respectively). Conclusion For the pain due to bone metastases, MRgFUS palliative treatment has definite short-term efficacy. Being a safe and non-invasive technique, MRgFUS palliative treatment is expected to become a promising therapeutic alternative for pain caused by bone metastasis.更多还原