Effectiveness and Safety of High-intensity Focused Ultrasound for Bone Tumors: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 WANGYing-qiang ^1,2 , LIXiang-lian ¹ ,  LIYou-ping ¹ , LUOQian-qian ³

1. Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China;
2. Department of Medical Administration, 363 Hospital, Chengdu 610041, China;
3. National Chengdu Center for Safety Evaluation of Drugs, Chengdu 610041, China;

Corresponding?author：

LIYou-ping, Email: yzmylab@hotmail.com

Keywords：

High-intensity focused ultrasound; Bone tumor; Osteosarcoma; Systematic review

DOI：

10.7507/1672-2531.20150055

Video：

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Objective To explore the effectiveness and safety of high-intensity focused ultrasound (HIFU) for bone tumors, so as to provide a reference for clinical decision. Methods PubMed, EMbase, The Cochrane Library, CNKI and VIP databases were systematically searched for clinical effectiveness and safety studies of HIFU for bone tumors up to August 2014. Study selection, data extraction and quality assessment were applied independently by two reviewers, and then RevMan 5.1 software was used for conducting meta-analysis. If the data cannot be synthesized, the research outcome was described with a qualitative analysis. Results A total of 10 case series including 257 patients (157 males, 100 females) were included. The current evidence indicated that overall survival rates for all primary bone malignancy at 1-, 2-, 3- and 5-year were 89.8%, 72.3%, 60.5% and 50.5%, respectively. For the patients with clinical stage Ⅱb, the rates were 93.3%, 82.4%, 75% and 63.7%, respectively. For those with clinical stage Ⅲ, the rates were 79.2%, 42.2%, 21.1% and 15.8%, respectively. The local recurrence rate of HIFU for bone tumors was 7% to 9%, and recurrences at 1-, 2-, 3- and 5-year were 0%, 6.2%, 11.8% and 11.8%, respectively. The amputation rate was 2% to 7%. The adverse reaction rate was 27.2% (70/257), and among them the main was mild skin burn (21/257, 8.2%), followed by I degree burns (16/257, 6.2%), nerve damage (10/257, 3.9%) and fracture (6/257, 2.3%). Conclusion HIFU provide an alternative choice for patients with bone malignancy, with a certain effectiveness and safety. However, high-quality, large-scale randomized controlled trials or cohort studies which may focus on vary kinds of tumors, clinical stage and site of lesions are urgently needed, so that clinicians can use sufficient evidence for their clinical decision-making.

Citation： WANGYing-qiang, LIXiang-lian, LIYou-ping, LUOQian-qian. Effectiveness and Safety of High-intensity Focused Ultrasound for Bone Tumors: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2015, 15(3): 327-334. doi: 10.7507/1672-2531.20150055 Copy

1.	Hameed M, Dorfman H. Primary malignant bone tumors--recent developments. Semin Diagn Pathol, 2011, 28(1):86-101.
2.	陳志峰, 陳萬青, 陳建國, 等. 中國腫瘤登記地區人群骨腫瘤發病分析. 中國腫瘤臨床, 2012, 39(20):1509-1513.
3.	Anract P.[Surgical management of primary bone cancer]. Bull Acad Natl Med, 2009, 193(1):107-126.
4.	Mavrogenis AF, Abati CN, Romagnoli C, et al. Similar survival but better function for patients after limb salvage versus amputation for distal tibia osteosarcoma. Clin Orthop Relat Res, 2012, 470(6):1735-1748.
5.	Hofer SO, Molema G, Hermens RA, et al. The effect of surgical wounding on tumour development. Eur J Surg Oncol, 1999, 25(3):231-243.
6.	Bogden AE, Moreau JP, Eden PA. Proliferative response of human and animal tumours to surgical wounding of normal tissues:onset, duration and inhibition. Br J Cancer, 1997, 75(7):1021-1027.
7.	劉正, 侯樹勛. 惡性骨腫瘤的高強度聚焦超聲治療研究進展. 中國骨腫瘤骨病, 2010, 9(3):259-262.
8.	Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses:the PRISMA statement. PLoS Med, 2009, 6(7):e1000097.
9.	Higgins JPT,Green S (editors).Cochrane handbook for systematic reviews of interventions version 5.1.0[updated March 2011]. The Cochrane Collaboration,2011.Available at:www.cochrane-handbook.org.
10.	曾憲濤, 劉慧, 陳曦, 等. Meta分析系列之四:觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4):297-299.
11.	Chen W, Zhu H, Zhang L, et al. Primary bone malignancy:effective treatment with high-intensity focused ultrasound ablation. Radiology, 2010, 255(3):967-978.
12.	陳文直, 王智彪, 伍烽, 等. 高強度聚焦超聲治療原發惡性骨腫瘤的初步臨床研究. 中華腫瘤雜志. 2002, 24(06):612-615.
13.	陳文直, 伍烽, 朱輝, 等. 高強度聚焦超聲治療骨肉瘤初步臨床觀察. 中國腫瘤臨床, 2001, 28(7):489-491.
14.	曾燕, 羅小平, 喻明憲, 等. 動脈灌注化療與高強度聚焦超聲聯合治療惡性骨腫瘤的血管造影變化. 重慶醫科大學學報, 2000, 25(04):411-413.
15.	曾燕, 羅小平, 淦偉, 等. 惡性骨腫瘤超聲聚焦刀與介入聯合治療后影像學檢查的初步研究. 臨床放射學雜志. 2000, 19(07):444-447.
16.	李仲全. 高強度聚焦超聲治療骨肉瘤的臨床應用研究. 中外醫療, 2013, (29):56-57.
17.	Wang Y, Wang W, Tang J. Primary malignant tumours of the bony pelvis:US-guided high intensity focused ultrasound ablation. Int J hyperthermia, 2013, 29(7):683-687.
18.	徐梅華, 蔡克銀. 高強度聚焦超聲治療老年骨轉移癌的近期療效. 中國老年學雜志, 2012, 32(20):4542-4543.
19.	胡文莉, 焦玉冰, 張浩, 等. 高強度聚焦超聲治療骶骨腫瘤19例分析. 人民軍醫, 2012, 55(2):161-162.
20.	莊開顏, 進克效, 焦玉冰, 等. 高強度聚焦超聲治療骶髂部骨腫瘤的初步臨床觀察. 解放軍醫學雜志. 2010, 35(04):474-474.
21.	李靜, 蓋綠華, 楊武威, 等. 低功率聚焦超聲對骨/軟組織腫瘤化療增敏作用的臨床觀察. 山東醫藥. 2008, 48(37):53-54.
22.	寇海燕, 孫鯤, 張宏, 等. 高強度聚焦超聲治療骨腫瘤15例. 武警醫學, 2006, 17(9):686-688.
23.	李偉兵, 章明, 白向君, 等. 惡性骨腫瘤的高強度聚焦超聲無創治療. 中國骨腫瘤骨病, 2003, 2(05):301-304, 317.
24.	Wiromrat P, Jetsrisuparb A, Komvilaisak P, et al. Incidence and survival rates among pediatric osteogenic sarcoma cases in Khon Kaen, Thailand, 1985-2010. Asian Pac Cancer Prev, 2012, 13(9):4281-4284.
25.	Xu M, Xu SF, Yu XC. Clinical analysis of osteosarcoma patients treated with high-dose methotrexate-free neoadjuvant chemotherapy. Curr Oncol, 2014, 21(5):e678-684.
26.	Liu Y, Xu Y, Lin N, et al. High-dose methotrexate (HD-MTX) used as an adjunct with other chemotherapeutics for the treatment of osteosarcoma. Cell Biochem Biophys, 2014.[Epub ahead of print].
27.	Tan PX,Yong BC,Wang J, et al. Analysis of the efficacy and prognosis of limb-salvage surgery for osteosarcoma around the knee. Eur J Surg Oncol, 2012,38(12):1171-1177.
28.	Sherman CE, O'Connor MI, Sim FH. Survival, local recurrence, and function after pelvic limb salvage at 23 to 38 years of follow-up. Clin Orthop Relat Res, 2012, 470(3):712-727.

1. Hameed M, Dorfman H. Primary malignant bone tumors--recent developments. Semin Diagn Pathol, 2011, 28(1):86-101.
2. 陳志峰, 陳萬青, 陳建國, 等. 中國腫瘤登記地區人群骨腫瘤發病分析. 中國腫瘤臨床, 2012, 39(20):1509-1513.
3. Anract P.[Surgical management of primary bone cancer]. Bull Acad Natl Med, 2009, 193(1):107-126.
4. Mavrogenis AF, Abati CN, Romagnoli C, et al. Similar survival but better function for patients after limb salvage versus amputation for distal tibia osteosarcoma. Clin Orthop Relat Res, 2012, 470(6):1735-1748.
5. Hofer SO, Molema G, Hermens RA, et al. The effect of surgical wounding on tumour development. Eur J Surg Oncol, 1999, 25(3):231-243.
6. Bogden AE, Moreau JP, Eden PA. Proliferative response of human and animal tumours to surgical wounding of normal tissues:onset, duration and inhibition. Br J Cancer, 1997, 75(7):1021-1027.
7. 劉正, 侯樹勛. 惡性骨腫瘤的高強度聚焦超聲治療研究進展. 中國骨腫瘤骨病, 2010, 9(3):259-262.
8. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses:the PRISMA statement. PLoS Med, 2009, 6(7):e1000097.
9. Higgins JPT,Green S (editors).Cochrane handbook for systematic reviews of interventions version 5.1.0[updated March 2011]. The Cochrane Collaboration,2011.Available at:www.cochrane-handbook.org.
10. 曾憲濤, 劉慧, 陳曦, 等. Meta分析系列之四:觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4):297-299.
11. Chen W, Zhu H, Zhang L, et al. Primary bone malignancy:effective treatment with high-intensity focused ultrasound ablation. Radiology, 2010, 255(3):967-978.
12. 陳文直, 王智彪, 伍烽, 等. 高強度聚焦超聲治療原發惡性骨腫瘤的初步臨床研究. 中華腫瘤雜志. 2002, 24(06):612-615.
13. 陳文直, 伍烽, 朱輝, 等. 高強度聚焦超聲治療骨肉瘤初步臨床觀察. 中國腫瘤臨床, 2001, 28(7):489-491.
14. 曾燕, 羅小平, 喻明憲, 等. 動脈灌注化療與高強度聚焦超聲聯合治療惡性骨腫瘤的血管造影變化. 重慶醫科大學學報, 2000, 25(04):411-413.
15. 曾燕, 羅小平, 淦偉, 等. 惡性骨腫瘤超聲聚焦刀與介入聯合治療后影像學檢查的初步研究. 臨床放射學雜志. 2000, 19(07):444-447.
16. 李仲全. 高強度聚焦超聲治療骨肉瘤的臨床應用研究. 中外醫療, 2013, (29):56-57.
17. Wang Y, Wang W, Tang J. Primary malignant tumours of the bony pelvis:US-guided high intensity focused ultrasound ablation. Int J hyperthermia, 2013, 29(7):683-687.
18. 徐梅華, 蔡克銀. 高強度聚焦超聲治療老年骨轉移癌的近期療效. 中國老年學雜志, 2012, 32(20):4542-4543.
19. 胡文莉, 焦玉冰, 張浩, 等. 高強度聚焦超聲治療骶骨腫瘤19例分析. 人民軍醫, 2012, 55(2):161-162.
20. 莊開顏, 進克效, 焦玉冰, 等. 高強度聚焦超聲治療骶髂部骨腫瘤的初步臨床觀察. 解放軍醫學雜志. 2010, 35(04):474-474.
21. 李靜, 蓋綠華, 楊武威, 等. 低功率聚焦超聲對骨/軟組織腫瘤化療增敏作用的臨床觀察. 山東醫藥. 2008, 48(37):53-54.
22. 寇海燕, 孫鯤, 張宏, 等. 高強度聚焦超聲治療骨腫瘤15例. 武警醫學, 2006, 17(9):686-688.
23. 李偉兵, 章明, 白向君, 等. 惡性骨腫瘤的高強度聚焦超聲無創治療. 中國骨腫瘤骨病, 2003, 2(05):301-304, 317.
24. Wiromrat P, Jetsrisuparb A, Komvilaisak P, et al. Incidence and survival rates among pediatric osteogenic sarcoma cases in Khon Kaen, Thailand, 1985-2010. Asian Pac Cancer Prev, 2012, 13(9):4281-4284.
25. Xu M, Xu SF, Yu XC. Clinical analysis of osteosarcoma patients treated with high-dose methotrexate-free neoadjuvant chemotherapy. Curr Oncol, 2014, 21(5):e678-684.
26. Liu Y, Xu Y, Lin N, et al. High-dose methotrexate (HD-MTX) used as an adjunct with other chemotherapeutics for the treatment of osteosarcoma. Cell Biochem Biophys, 2014.[Epub ahead of print].
27. Tan PX,Yong BC,Wang J, et al. Analysis of the efficacy and prognosis of limb-salvage surgery for osteosarcoma around the knee. Eur J Surg Oncol, 2012,38(12):1171-1177.
28. Sherman CE, O'Connor MI, Sim FH. Survival, local recurrence, and function after pelvic limb salvage at 23 to 38 years of follow-up. Clin Orthop Relat Res, 2012, 470(3):712-727.

Chinese Journal of Evidence-Based Medicine

Effectiveness and Safety of High-intensity Focused Ultrasound for Bone Tumors: A Systematic Review

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