Prospective 1-year follow-up pilot study of CT-guided microwave ablation in the treatment of bone and soft-tissue malignant tumours

Abstract

• CT-guided MWA is efficient in treating musculoskeletal malignant tumours. • This prospective pilot study showed MWA induces high percentages of tumour necrosis. • MWA has good short-term anti-cancer effects. • MWA has healing potential when lesions can be completely necrosed. • CT-guided MWA under equimolar mixture of oxygen-nitrous oxide inhalation is well tolerated.

Magnetic Resonance–Guided Focused Ultrasound Surgery for Bone Metastasis: From Pain Palliation to Biological Ablation?

“…21e23 High percentage of tumor necrosis (85% at one month) was reported in a small prospective study on nine bone metastases and five soft-tissue sarcomas. 22 Another study compared radiofrequency and microwave ablation and found them equally effective in reducing various pain measures one, four, and eight weeks after treatment. Compared to radiofrequency, microwave ablation time was slightly shorter, but the procedure was found to be more expensive.…”

Thermal Ablation of Bone Metastases

“…Using current systems, up to three antennae may be operated simultaneously and synergistically to create ablation zones up to 6 cm in size as reported for musculoskeletal tumors. 24 Microwave energy has theoretical advantages over RF energy, including faster heating of a larger volume of tissue with decreased heat sink effects. 23 Due to bone's low conductivity, microwave energy should theoretically provide better tissue penetration when treating OM than RF energy.…”

“…A single, prospective, pilot study and smaller retrospective case series have shown MWA to produce safe pain palliation and effective tumor necrosis. 24,[44][45][46][47][48] Evidence for LA is limited to a few reported cases. 26,49 Local Control of Oligometastatic Disease…”

“…In a focused approach analogous to stereotactic body radiotherapy treatment strategies, [50][51][52] several studies have recently shown that thermal ablation may produce safe, effective, and durable local control of OM in appropriately selected patients utilizing CA, RFA, or MWA. 24,41,[53][54][55][56][57][58][59][60][61][62] This targeted ablation approach can delay or avoid the need for systemic adjuvant therapies and avoid any associated side effects. 55 However, evidence evaluating the role of thermal ablation in treating oligometastatic OM remains limited to multiple retrospective case series and a solitary prospective MWA pilot study for mixed indications.…”

Percutaneous Image-Guided Treatment of Benign Musculoskeletal Tumors in Children

“…A few recent trials demonstrated efficacy and safety in the treatment of OO, although RFA remains the standard for thermal ablation in this entity. 5,6 Laser Ablation…”