Analgesic efficacy and safety of percutaneous thermal ablation plus cementoplasty for painful bone metastases: a systematic review and meta-analysis,International Journal of Clinical Oncology

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Analgesic efficacy and safety of percutaneous thermal ablation plus cementoplasty for painful bone metastases: a systematic review and meta-analysis
International Journal of Clinical Oncology ( IF 2.4 ) Pub Date : 2024-01-13 , DOI: 10.1007/s10147-023-02458-z
Tomohiro Matsumoto ₁ , Rika Yoshimatsu _{1,

2} , Marina Osaki _{1,

2} , Junki Shibata ₁ , Hitomi Maeda ₁ , Kana Miyatake ₁ , Yoshinori Noda ₁ , Tomoaki Yamanishi ₁ , Takuji Yamagami ₁

Affiliation

Purpose

To conduct a systematic review and meta-analysis of publications to evaluate the analgesic efficacy and safety of percutaneous thermal ablation (PTA) plus percutaneous cementoplasty (PCP) (PTA + PCP) for painful bone metastases.

Methods

We searched PubMed, Cochrane Library and Embase for articles published up to October 2022. Outcomes were a 10-point pain scale, morphine equivalents daily dose (MEDD) and complications. A subgroup confined to spinal bone metastases was analyzed.

Results

Twenty-one articles were selected for the analysis. The 21 selected articles involved a total of 661 cases. The pooled pain scales at pre-PTA + PCP, 1 day, 1 week and 1-, 3-, and 6 months post-PTA + PCP were 7.60 (95% confidence interval [CI], 7.26–7.95, I² = 89%), 3.30 (95% CI, 2.25–4.82, I² = 98%), 2.58 (95% CI, 1.99–3.35, I² = 94%), 2.02 (95% CI, 1.50–2.71, I² = 93%), 1.78 (95% CI, 1.26–2.53, I² = 95%), and 1.62 (95% CI, 1.14–2.31, I² = 88%), and in the subgroup, 7.97 (95% CI, 7.45–8.52, I² = 86%), 3.01 (95% CI, 1.43–6.33, I² = 98%), 2.95 (95% CI, 1.93–4.51, I² = 95%), 2.34 (95% CI, 1.82–3.01, I² = 68%), 2.18 (95% CI, 1.57–3.03, I² = 78%), and 2.01 (95% CI, 1.16–3.48, I² = 86%). Mean MEDD decreased up to 3 months post-PTA + PCP in 4 articles. The overall pooled major complication rate was 4% (95% CI, 2–6%, I² = 2%).

Conclusions

The updated systematic review and meta-analysis indicates that PTA + PCP for painful bone metastases is safe, and can lead to rapid and sustained pain reduction.

中文翻译：

经皮热消融加骨水泥成形术治疗疼痛性骨转移的镇痛功效和安全性：系统评价和荟萃分析

目的

对出版物进行系统回顾和荟萃分析，以评估经皮热消融术（PTA）加经皮骨水泥成形术（PCP）（PTA + PCP）治疗疼痛性骨转移的镇痛功效和安全性。

方法

我们检索了 PubMed、Cochrane 图书馆和 Embase，查找截至 2022 年 10 月发表的文章。结果包括 10 点疼痛量表、吗啡当量每日剂量 (MEDD) 和并发症。分析了仅限于脊柱骨转移的亚组。

结果

选择了二十一篇文章进行分析。入选的21篇文章共涉及661个案例。 PTA + PCP 前、PTA + PCP 后 1 天、1 周以及 1、3 和 6 个月的汇总疼痛量表为 7.60（95% 置信区间 [CI]，7.26–7.95， I ² = 89 %), 3.30 (95% CI, 2.25–4.82, I ² = 98%), 2.58 (95% CI, 1.99–3.35, I ² = 94%), 2.02 (95% CI, 1.50–2.71, I ² = 93%）、1.78（95% CI，1.26–2.53， I ² = 95%）和 1.62（95% CI，1.14–2.31， I ² = 88%），在亚组中，7.97（95% CI， 7.45–8.52, I ² = 86%), 3.01 (95% CI, 1.43–6.33, I ² = 98%), 2.95 (95% CI, 1.93–4.51, I ² = 95%), 2.34 (95% CI ，1.82–3.01， I ² = 68%）、2.18（95% CI，1.57–3.03， I ² = 78%）和 2.01（95% CI，1.16–3.48， I ² = 86%）。 4 篇文章中，平均 MEDD 在 PTA + PCP 后 3 个月内下降。总体主要并发症发生率为 4%（95% CI，2-6%， I ² = 2%）。