Zhilong Wang, Taiyang Zuo, Wenli Lin, Zhenhua Du, Xiaofan Zhang, Yining Liang

Clinical Efficacy and Safety of Microwave Ablation combined with Percutaneous Osteoplasty for Palliative Treatment in pelvic osteolytic metastases

  • Radiology, Nuclear Medicine and imaging
  • General Medicine

Abstract Objective To evaluate the impact of microwave ablation (MWA) on pain relief, quality of life (QOL), mobility, and local tumor progression in adult patients with pelvic osteolytic bone metastasis and to test the safety of microwave ablation. Methods This study retrospectively analyzed the data from 20 patients with pelvic osteolytic metastases who received MWA combined with percutaneous osteoplasty (POP). The visual analogue scale (VAS), Musculoskeletal tumor society system (MSTS), and Quality of Life Questionnaire-Bone Metastases 22 (QLQ-BM22) were used to evaluate the pain, limb function, and quality of life. The intraoperative and postoperative complications were recorded. The tumor recurrence and survival time were analyzed during the follow-up period (range 3-26 months). Results All (n = 20) MWA and POP operations were completed successfully. Four patients (20%; 95% CI, 6%-44%) had mild bone cement leakage from surrounding tissues, and there were no obvious symptoms or serious complications. There were significant differences in VAS, MSTS, and QLQ-BM22 scores before and after the operation (P < 0.001). During the postoperative follow-up period, 9 patients died. The median survival time was 8 months (range 3-26 months; IQR: 4.5-13; 95% CI, 4.2-15.3 mo), and the 1-year survival rate was 65% (13/20; 95% CI, 41%-85%). Tumor recurrence occurred in 4 cases (20%; 95% CI, 6%-44%) after the operation, and the median time of recurrence was 12 months (range 8-16 months; IQR: 8.25-12.75; 95% CI, 5.5-18.5 mo). Conclusion MWA combined with POP is an effective and safe treatment for pelvic osteolytic metastases. It can significantly relieve local pain, reconstruct limb function, improve patients’ quality of life and effectively control local tumor progression. Advances in knowledge So far, the experience of using microwave in the treatment of pelvic metastases is still limited. MWA combined with POP in the treatment of pelvic osteolytic metastases can provide significant clinical benefits in acceptable low-risk minimally invasive situations and should be provided to patients with appropriate pelvic metastases in a multidisciplinary approach.

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