Lin ZP, Zou XG, Huang DB, Chen Y, Lin JW, Li XQ, Zhang J. Efficacy and safety of C-arm computed tomography-guided microwave ablation with percutaneous osteoplasty for flat bone metastases. World J Clin Oncol 2025; 16(3): 101681 [DOI: 10.5306/wjco.v16.i3.101681]
Corresponding Author of This Article
Jian Zhang, Doctor, Chief Physician, Department of Interventional Medicine, Zhongshan People’s Hospital, No. 2 Sunwen East Road, Zhongshan 528400, Guangdong Province, China. wy18988583838@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Zhi-Peng Lin, Xu-Gong Zou, Da-Bei Huang, Yuan Chen, Jia-Wen Lin, Xiao-Qun Li, Jian Zhang, Department of Interventional Medicine, Zhongshan People’s Hospital, Zhongshan 528400, Guangdong Province, China
Author contributions: Lin ZP, Zou XG, and Huang DB participated in the conception and design of the study and were involved in the acquisition, analysis, or interpretation of data; Lin ZP, Chen Y, and Lin JW wrote the manuscript; Li XQ and Zhang J accessed and verified the study data; all authors critically reviewed and provided final approval of the manuscript, and were responsible for the decision to submit the manuscript for publication.
Institutional review board statement: The Ethics Committee of Zhongshan People’s Hospital approved this retrospective study (Ethics approval number: 2024-043).
Informed consent statement: The need for individual consent was waived due to the retrospective nature of the study.
Conflict-of-interest statement: The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data sharing statement: The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian Zhang, Doctor, Chief Physician, Department of Interventional Medicine, Zhongshan People’s Hospital, No. 2 Sunwen East Road, Zhongshan 528400, Guangdong Province, China. wy18988583838@163.com
Received: September 23, 2024 Revised: December 1, 2024 Accepted: December 27, 2024 Published online: March 24, 2025 Processing time: 120 Days and 0.9 Hours
Abstract
BACKGROUND
Flat bone metastases are common in patients with advanced cancers, often resulting in severe pain, limited mobility, and reduced quality of life (QOL). Traditional treatment options, such as radiotherapy or systemic therapies, often fail to provide sufficient pain relief or improve functional outcomes in these patients. Microwave ablation (MWA) offers advantages, such as shorter procedure times and larger ablation zones, while percutaneous osteoplasty (PO) enhances bone stability and prevents pathological fractures. Despite these benefits, the combination of these techniques for treating flat bone metastases remains underexplored.
AIM
To evaluate the efficacy and safety of C-arm computed tomography (CT)-guided MWA combined with PO for managing painful flat bone metastases, focusing on pain relief, functional improvement, and QOL enhancement.
METHODS
A total of 45 patients with refractory moderate-to-severe pain resulting from flat bone metastases who underwent C-arm CT-guided MWA combined with PO between January 2015 and January 2021 were included. The efficacy of the procedure was assessed by changes in the visual analog scale (VAS), Oswestry disability index (ODI), and QOL, as well as the occurrence of complications. Tumor response was evaluated using RECIST v1.1 and mRECIST criteria, with overall response rate (ORR) and disease control rate (DCR) as the primary endpoints.
RESULTS
No serious complications were observed in any of the patients. A significant reduction in VAS and ODI was noted at 1 week, 1 month, and 3 months post-procedure. A marked improvement in QOL was observed at all follow-up points. Bone cement extravasation was observed in 10 patients; however, none exhibited significant clinical symptoms. Based on RECIST v1.1, the ORR was 26.7% and the DCR was 88.9%. The mRECIST evaluation revealed a higher ORR of 51.1% and DCR of 88.9%.
CONCLUSION
C-arm CT-guided MWA with PO provides a dependable and effective strategy for managing flat bone metastases. It demonstrates significant pain relief, improved functional outcomes, and enhanced QOL. This treatment combination also shows promising tumor response rates with a low complication profile.
Core Tip: This study retrospectively evaluated the effectiveness and safety of using C-arm computed tomography-guided microwave ablation in conjunction with percutaneous osteoplasty to manage painful flat bone metastases. The key outcomes included postoperative pain relief, functional improvement, quality of life (QOL) enhancement, and occurrence of serious complications. The results indicate that this combined therapy is effective and safe for managing painful flat bone metastases. It offers significant benefits for pain control, functionality, and QOL.
