Computed tomography-guided microwave ablation combined with osteoplasty for the treatment of bone metastases: a multicenter clinical study.

PURPOSE To evaluate the efficacy and safety of combined microwave ablation (MWA) and osteoplasty as palliative therapy for painful bone metastases. MATERIALS AND METHODS This was an extension study of our previous single-center study on extraspinal bone metastases. A retrospective review was conducted for 147 patients (77 men, 70 women) with painful bone metastases who underwent MWA combined with osteoplasty. In total, 102 (69.4%) patients had spinal metastases, 41 (27.9%) had extraspinal metastases, and four (2.7%) had both. Treatment efficacy was determined by comparing visual analog scale (VAS) scores, daily morphine equivalent opioid consumption, and Oswestry Disability Index (ODI) scores before treatment and during the follow-up period (mean follow-up, 9.8 months; range, 3-16 months). RESULTS The mean VAS score declined significantly from 6.4 ± 2.3 before treatment to 3.2 ± 2.1 at 24 hours, 1.9 ± 1.58 at 1 week, 1.78 ± 1.60 at 4 weeks, 1.82 ± 1.58 at 12 weeks, and 1.86 ± 1.57 at 24 weeks post-treatment, respectively (P < 0.01). The mean daily morphine equivalent consumption of opioids was also significantly reduced from 81.5 ± 32.8 mg before treatment to 40.01 ± 20.57 mg at 24 hours, 32.36 ± 10.22 mg at 1 week, 26.35 ± 10.01 mg at 4 weeks, 21.54 ± 8.32 mg at 12 weeks, and 19.33 ± 7.38 mg at 24 weeks post-treatment. The mean ODI score was lower post-treatment than that before treatment (P < 0.0001). Major complications occurred in 4/147 patients, with one pathological fracture, one nerve injury, and one mild skin infections. Minor cement leakages were observed at 69 sites (32.8%). CONCLUSIONS MWA combined with osteoplasty is an effective and safe treatment for painful bone metastases.