Combining radiotherapy and focused ultrasound for pain palliation of cancer induced bone pain; a stage I/IIa study according to the IDEAL framework

Clinical and Translational Radiation Oncology

Cyril J. Ferrer¹  Inez M. Verpalen²  Wietse S.C. Eppinga³  Derk J. Slotman⁴  Harry R. Naber⁴  Lambertus W. Bartels⁴  Ingrid M. Nijholt⁴  Erwin de Boer⁴  Clemens Bos⁴  Joost J.C. Verhoeff⁴  Marcia M.T.J. Bartels⁵  Manon N.G.J.A. Braat⁵  Rolf D. van den Hoed⁵  Miranda van 't Veer-Ten Kate⁶  Martijn F. Boomsma⁷  Chrit T.W. Moonen⁷  Erik C.J. Phernambucq⁷  Helena M. Verkooijen⁷ 

[1] Corresponding author at: Heidelberglaan 100, Internal mail Q.00.311, 3584 CX Utrecht, The Netherlands.;University Medical Center Utrecht, Department of Radiology, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands;Isala Hospital, Department of Radiation Oncology, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands;Isala Hospital, Department of Radiology, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands;University Medical Center Utrecht, Department of Radiation Oncology, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands;University Medical Center Utrecht, Department of Radiology, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands;University Medical Center Utrecht, Image Sciences Institute, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands;

关键词: Cancer pain;    Palliative care;    Palliative therapy;    Pain management;    Neoplasm metastasis;    Bone and bones;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Cancer induced bone pain (CIBP) strongly interferes with patient’s quality of life. Currently, the standard of care includes external beam radiotherapy (EBRT), resulting in pain relief in approximately 60% of patients. Magnetic Resonance guided High Intensity Focused Ultrasound (MR-HIFU) is a promising treatment modality for CIBP. Methods: A single arm, R-IDEAL stage I/IIa study was conducted. Patients presenting at the department of radiation oncology with symptomatic bone metastases in the appendicular skeleton, as well as in the sacrum and sternum were eligible for inclusion. All participants underwent EBRT, followed by MR-HIFU within 4 days. Safety and feasibility were assessed, and pain scores were monitored for 4 weeks after completing the combined treatment. Results: Six patients were enrolled. Median age was 67 years, median lesion diameter was 56,5 mm. In all patients it was logistically possible to plan and perform the MR-HIFU treatment within 4 days after EBRT. All patients tolerated the combined procedure well. Pain response was reported by 5 out of 6 patients at 7 days after completion of the combined treatment, and stabilized on 60% at 4 weeks follow up. No treatment related serious adverse events occurred. Conclusion: This is the first study to combine EBRT with MR-HIFU. Our results show that combined EBRT and MR-HIFU in first-line treatment of CIBP is safe and feasible, and is well tolerated by patients. Superiority over standard EBRT, in terms of (time to) pain relief and quality of life need to be evaluated in comparative (randomized) study.

【 授权许可】

Unknown