title: [Magnetic resonance guided focused ultrasound surgery for pain palliation of bone metastases: early experience of clinical application in China].
abstract: OBJECTIVE
  To evaluate the safety and efficacy of magnetic resonance guided focused ultrasound surgery (MRgFUS) in treatment for pain palliation of bone metastases.
  
  
  METHODS
  Eighty-one patients of painful bone metastases were volunteered to screen for this study in Shanghai General Hospital from June 2014 to February 2015. Twenty-three 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 Metastases 22 (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)Twenty-three metastatic bone tumor lesions of 23 patients were treated by MRgFUS, the treatment data was as follows: the mean treatment time was (88 ± 33) minutes, the mean sonication number was 13 ± 8. (2) Adverse events included: pain in therapy area 3/23, which spontaneous relieving within one week; numbness in lower limb (1/23), which relieved after physiotherapy. (3) The NRS of before treatment and at 1-week, 1-month, and 3-month after treatment respectively was 6.0 ± 1.5, 3.7 ± 1.7,3.1 ± 2.0, and 2.2 ± 1.0,which significantly decreased after the treatment (P<0.01). (4) The BPI-QoL score of before treatment and at 1-week, 1-month, and 3-month after treatment respectively was 39 ± 16, 27 ± 18, 26 ± 18, and 21 ± 18, which significantly decreased after the treatment (P<0.01). (5) The EORTC QLQ-BM22 score of before treatment and at 1-week, 1-month, and 3-month after treatment respectively was 52 ± 13, 44 ± 12, 42 ± 12, and 39 ± 12, which also significantly decreased after the treatment (P<0.01).
  
  
  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.
authors.affiliation: Department of Radiology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Gu
authors.affiliation: Email: bingowh@hotmail.com.
authors.forename: Han
authors.initials: H
authors.lastname: Wang
authors.forename: Na
authors.initials: N
authors.lastname: Tang
authors.forename: Yingqi
authors.initials: Y
authors.lastname: Hua
authors.forename: Haiyan
authors.initials: H
authors.lastname: Yang
authors.forename: Yimin
authors.initials: Y
authors.lastname: Qiu
authors.forename: Renbin
authors.initials: R
authors.lastname: Ge
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhou
authors.forename: Wenwen
authors.initials: W
authors.lastname: Wang
authors.forename: Guixiang
authors.initials: G
authors.lastname: Zhang
mesh_terms: D001859:Bone Neoplasms; D002681:China; D006769:Hospitals, General; D006801:Humans; D035002:Lower Extremity; D009682:Magnetic Resonance Spectroscopy; D010146:Pain; D059408:Pain Management; D010147:Pain Measurement; D010166:Palliative Care; D011788:Quality of Life; D011795:Surveys and Questionnaires