Short-term efficacy and safety of MR-guided focused ultrasound surgery for analgesia in children with metastatic bone tumors

Abstract

Short-term efficacy and safety of magnetic resonance-guided focused ultrasound surgery (MRgFUS) for analgesia in children with metastatic bone tumors were studied. Thirty children with pediatric bone metastases admitted to Jinan Maternity and Child Care Hospital from March 2015 to March 2018 and who received MRgFUS treatment of the bone metastasis lesions were collected. The postoperative efficacy was assessed. The observation indicators included the Numerical Rating Scale (NRS) scores, European Organization for Research and Treatment of Cancer (EORTC) and Quality of Life Questionnaire (QLQ) scores before surgery, and 1 week, 1, 2, and 3 months after surgery and the Karnofsky Performance Status (KPS) scores before surgery, and 1 week and 3 months after surgery. The adverse reactions and medications of the children after the surgery were also under observation. NRS and VAS scores of all different observation time-points after surgery were statistically lower than those before surgery (P<0.05), and the NRS scores and Visual Analog Scale (VAS) scores 3 months after surgery were lower than those 1 week after surgery (P<0.05). Compared with the preoperative conditions, the QLQ-C30 scores of terms like physical function, cognitive function, nausea and vomiting, and degree of pain 1 week, 1, 2, and 3 months after surgery were decreased, and the clinical symptoms of the children were relieved (P<0.05). There was a statistical difference between the total QLQ-C30 scores 3 months after operation and the total QLQ-C30 scores 3 months before operation (P<0.05). No serious adverse reactions related to treatment were reported, and the application of analgesics was reduced. MRgFUS relieves bone metastasis pain in children with good curative effect and high safety.

Keywords: MR-guided focused ultrasound; analgesia; efficacy; metastatic bone tumors in children; safety.

Figure 1.

Score of the analgesia efficacy after MRgFUS. NRS and VAS scores of all different observation time-points after surgery were statistically lower than those before surgery (P<0.05), and NRS and VAS scores 3 months after surgery were lower than those 1 week after surgery (P<0.05). The analgesic effect was relatively sustained. ^aP<0.05, when compared with the NRS and VAS scores before surgery; ^bP<0.05, when compared with the NRS and VAS scores 1 week after surgery; ^cP<0.05, when compared with the NRS and VAS scores 1 month after surgery. MRgFUS, magnetic resonance-guided focused ultrasound surgery; NRS, Numerical Rating Scale; VAS, visual analog scale.

Figure 2.

QLQ-C30 scores before and after treatment (1). Compared with the preoperative conditions, QLQ-C30 scores such as physical function, cognitive function and total QLQ-C30 scores 1 week, 1, 2, and 3 months after surgery were statistically lower than those before surgery (P<0.05). ^aP<0.05, when compared with QLQ-C30 scores before surgery; ^bP<0.05, when compared with QLQ-C30 scores 1 week after surgery; ^cP<0.05, when compared with QLQ-C30 scores 1 month after surgery. QLQ, Quality of Life Questionnaire.

Figure 3.

QLQ-C30 scores before and after treatment (2). Compared with the preoperative conditions, QLQ-C30 scores such as nausea, vomiting, feeling painful, constipation, and diarrhea 1 week, 1, 2, and 3 months after surgery were lower, and clinical symptoms of children were all relieved to different extent (P<0.05). ^aP<0.05, when compared with QLQ-C30 scores before surgery; ^bP<0.05, when compared with QLQ-C30 scores 1 week after surgery; ^cP<0.05, when compared with QLQ-C30 scores 1 month after surgery; ^dP<0.05, when compared with QLQ-C30 scores 2 months after surgery. QLQ, Quality of Life Questionnaire.