Top orthopedics journal showcases TMU cancer study

Although medical advances are helping stage-4 cancer patients survive longer, bone metastases cause serious and difficult-to-treat pain. In January 2014, TMU became the first Asian medical institution to employ MRI-guided conformal thermal therapy.

Since then, TMU hospitals have successfully treated 120 cancer patients with bone metastases, the highest number of patients treated worldwide. Their treatment results were published in the Journal of Bone and Joint Surgery, ranked first in the orthopedics field.

The research was led by Prof. Jeng-Fong Chiou, TMU Taipei Cancer Center executive deputy superintendent and TMU Hospital radiology director.

The team analyzed bone metastases in 63 breast, prostate and colorectal cancer patients, comparing responses to traditional radiation therapy with those of the new technology. They found that the rate of treatment response to MRI-guided conformal thermal therapy during the first week equalled the response rate of one to three months of traditional treatment, thus demonstrating superior pain relief in the thermal therapy group.

In the 21 patients who received MRI-guided conformal thermal therapy, 71% showed alleviation of pain or reduced painkiller dosages after one week, compared with the 26% response in radiation therapy patients during the same period. After one month of follow-up, thermal treated patients showed 81% effectiveness in pain alleviation, compared with 67% in radiation therapy patients.

During thermal treatment (left), MRI-generated images allow technicians to monitor temperatures in real time (right) to ensure safety.

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Thermal therapy and radiation therapy can both kill cancer cells that have metastasized within bones, but thermal therapy can also help reduce the pain detected by nerves on the periosteum that the metastatic cancer cells have invaded. With the additional effect of blocking the nerves, pain relief comes just one to three days after treatment begins, while pain relief in radiation therapy only comes after approximately a month of treatment, with ten to fifteen treatments needed to accumulate sufficient radiation dosage to reduce tumor size. MRI-guided conformal thermal therapy accurately pinpoints metastases as well as the nerves being invaded. Supersonic waves focus and generate heat higher than 60 degrees to reduce the target tumor and achieve pain relief. During the process MRI images allow technicians to monitor temperatures in real time to ensure safety. This is the only high-temperature treatment technique approved by the U.S. FDA for patients with bone metastases.

Prof. Jeng-Fong Chiou says cancer patients who receive traditional radiation treatment have a close to 30% chance of relapse in the same location, while patients who undergo thermal treatment have an extremely low chance of relapse, typically less than 5%. After TMU Hospital introduced MRI-guided conformal thermal therapy, it also received national quality certification. The team will continue their research and expand thermal therapy for new indications such as to osteoarthritis and neuropathy.

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