Percutaneous microwave ablation of bone tumors: a systematic review

被引:54
作者
Cazzato, Roberto Luigi [1 ]
de Rubeis, Gianluca [2 ]
de Marini, Pierre [1 ]
Dalili, Danoob [3 ,4 ]
Koch, Guillaume [1 ]
Auloge, Pierre [1 ]
Garnon, Julien [1 ]
Gangi, Afshin [1 ]
机构
[1] Univ Hosp Strasbourg, Intervent Radiol, 1 Pl Hop, F-67000 Strasbourg, France
[2] Sapienza Univ Rome, Vasc & Intervent Radiol Unit, Dept Diagnost Radiol Oncol & Anatomopathol Sci, Viale Policlin 155, I-00161 Rome, Italy
[3] Oxford Univ Hosp NHS Fdn Trust, Nuffield Orthopaed Ctr, Windmill Rd, Oxford OX3 7LD, England
[4] Kings Coll London, Sch Biomed Engn & Imaging Sci, London WC2R 2LS, England
关键词
Microwaves; Bone; Neoplasms; Safety; Pain;
D O I
10.1007/s00330-020-07382-8
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
AimTo systematically review microwave ablation (MWA) protocols, safety, and clinical efficacy for treating bone tumors.Materials and methodsA systematic literature search was conducted using PubMed, the Cochrane Library, EMBASE, and Web of Science database. Data concerning patient demographics, tumor characteristics, procedure, complications, and clinical outcomes were extracted and analyzed.ResultsSeven non-comparative studies (6 retrospective, 1 prospective) were included accounting for 249 patients and 306 tumors (244/306 [79.7%] metastases; 25/306 [8.2%] myelomas, and 37/306 [12.1%] osteoid osteomas [OO]). In malignant tumors, MWA power was 30-70 W (except in one spinal tumors series where a mean power of 13.3 W was used) with pooled mean ablation time of 308.3 s. With OO, MWA power was 30-60 W with mean ablation time of 90-102 s. Protective measures were very sporadically used in 5 studies. Additional osteoplasty was performed in 199/269 (74.0%) malignant tumors. Clinically significant complications were noted in 10/249 (4.0%) patients. For malignant tumors, estimated pain reduction on the numerical rating scale was 5.3/10 (95% confidence intervals [95%CI] 4.6-6.1) at 1 month; and 5.3/10 (95% CI 4.3-6.3) at the last recorded follow-up (range 20-24 weeks in 4/5 studies). For OO, at 1-month follow-up, effective pain relief was noted in 92.3-100% of patients.ConclusionMWA is effective in achieving pain relief at short- (1 month) and mid-term (4-6 months) for painful OO and malignant bone tumors, respectively. Although MWA seems safe, further prospective studies are warranted to further assess this aspect, and to standardize MWA protocols.Key Points center dot Large heterogeneity exists across literature about ablation protocols used with microwave ablation applied for the treatment of benign and malignant bone tumors.center dot Although microwave ablation of bone tumors appears safe, further studies are needed to assess this aspect, as current literature does not allow definitive conclusions.center dot Nevertheless, microwave ablation is effective in achieving pain relief at short- (1 month) and mid-term (4-6 months) for painful osteoid osteomas and malignant bone tumors, respectively.
引用
收藏
页码:3530 / 3541
页数:12
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