In a study published by the Journal of National Cancer Institute
Hurwitz et al report on findings of a multicenter phase III trial regarding the
efficacy and safety of magnetic resonance-guided focused ultrasound (MRgFUS),
for palliation of pain due to bone metastases.
One hundred forty-seven patients were
enrolled, with 112 and 35 randomly assigned to MRgFUS and placebo treatments,
respectively. The 147
patients were treated in 17 centers in the U.S., Canada, Israel, Italy and
Russia. Response rate for the primary endpoint, improvement in
self-reported pain score without increase of pain medication 3 months after
treatment, was 64.3% in the MRgFUS arm and 20.0% in the placebo arm (P <
.001). MRgFUS was also superior to placebo at 3 months on the secondary
endpoints assessing worst score Numerical Rating Scale for pain (NRS) and
morphine equivalent daily dose intake (P < .001) and Brief Pain Inventory
(BPI-QoL), a measure of functional interference of pain on quality of life (P
< .001). The most common treatment-related adverse event was sonication
pain, which occurred in 32.1% of patients. Two patients had pathological
fractures, one patient had third-degree skin burn, and one patient suffered
from neuropathy. Overall 60.3% of all treatment-related adverse events resolved
on same day the sonication treatment was delivered.
The authors
concluded that MRgFUS, a non-invasive technique, can relieve pain and improve function in
most patients with skeletal metastases who have failed standard treatment such
as radiation therapy.
