Zhipeng Lin, Xiaolong Hu, Dabei Huang, Xugong Zou, Yuan Chen, Xiaoqun Li, Jian Zhang

Department of Interventional Medicine, Zhongshan People’s Hospital, Guangdong, 528400, People’s Republic of China

Correspondence: Jian Zhang, Email wy18988583838@163.com

Purpose: Evaluating the clinical efficacy and safety of microwave ablation combined with percutaneous osteoplasty (MWA + PO group) versus percutaneous osteoplasty (PO group) for the treatment of flat bone metastases.
Methods: Patients with flat bone metastases and intractable pain who underwent PO and/or MWA from January 2016 to January 2023 in our hospital were included, with 36 cases in the MWA+PO group and 21 cases in the PO group. Changes in the visual analog scale (VAS), Oswestry Disability Index (ODI), and quality of life assessment scale(QOL) were evaluated regularly. Postoperative complications and target lesion tumor treatment responses were also observed.
Results: The VAS and ODI in both the MWA+PO group and the PO group significantly decreased at 1 week, 1 month, and 3 months postoperatively, The VAS and ODI in the MWA+PO group were lower than those in the PO group postoperatively. The QOL in both the MWA+PO group and the PO group significantly increased at 1 week, 1 month, and 3 months postoperatively, with the QOL in the MWA+PO group being higher than that in the PO group postoperatively. According to the mRECIST criteria (target lesion tumor treatment response), the ORR in the MWA+PO group and PO group was 52.8% and 9.5%, respectively, while the DCR was 94.4% and 57.1%, respectively (P < 0.001 and< 0.001). Different degrees of bone cement extravasation were observed in both the PO group (38.1%) and MWA+PO group(19.4%)(χ²=2.38, P=0.12), but none of the patients developed clinical symptoms related to bone cement extravasation. The average cost of surgery was ¥ 10,480.43 higher in the MWA+PO group than in the PO group.
Conclusion: The MWA+PO treatment is more effective in relieving patients’ local pain, improving local dysfunction, and enhancing quality of life, and can effectively improve target lesion tumor ORR and DCR, but it is also more costly.

Keywords: microwave ablation, percutaneous osteoplasty, bone metastases