Treatment of osteosarcoma with high-intensity focused ultrasound: Preliminary clinical outcomes in one center

摘要

OBJECTIVE: To evaluate the effect of high-intensity focused ultrasound (HIFU) in the treatment ofosteosarcoma.PATIENTS AND METHODS: From November 2000 to May 2004, by using a model JC focusedultrasound therapeutic system, 25 osteosarcoma patients (15 males and 10 females aging 6 - 44 yearsold and with mean ages of 17.7±8.5 years old; surgical stage were 20 Iib and 5 IIIb) receivedextracorporeal HIFU ablation in our center. All patients received conventional neoadjuvantchemotherapy and adjuvant chemotherapy after HIFU ablation. All patients were followed with clinicalexaminations, chest x-ray, bone scan and enhanced MRI every 3 to 6 months for two years.RESULTS: The nuclide uptake in bone scan and gadolinium enhancement in MRI of the target lesionwas elminated after effective HIFU ablation. A total of 35 HIFU sessions were performed to the 25patients. Local complete ablations evaluated by images were achieved in 23 patients (92%), in which19 patients received one HIFU session, 2 received 2 sessions and 2 received 3 sessions. Till now, themedian follow-up times were 21 months (ranging 1-43 months. There were 24 patients (96%) survivedwith 20 months of median survival time, 19 patients (76%) survived relapse-free, 4 patients newlydeveloped lung metastasis, and 2 developed local recurrence. Eleven major complications such asperipheral nerve injury and pathologic fracture were observed in 10 patients. One patient died of lungmetastasis 5 months after HIFU ablation.CONCLUSIONS: The preliminary results showed that effective and complete ablation of osteosarcomalesions could be achieved by extracorporeal HIFU, which may become a new limb salvaging methodsfor patients with osteosarcoma.