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Objective:
With the development of minimally invasive techniques, the application of thermal ablation in thyroid, breast, liver, and other diseases is increasing. Thermal ablation can provide both radical curative effect for benign lesions and palliative treatment for metastatic tumors. However, its reports in bone tumors are limited. The study aimed to evaluate the clinical efficacy of ultrasound-guided percutaneous microwave ablation (MWA) in patients with painful bone tumors.

Materials and Methods:
The clinical data of 25 painful bone tumors in 15 patients who underwent percutaneous MWA in Sichuan Cancer Hospital from May 2020 to June 2022 were retrospectively analyzed. Tumor pathologies included the following: cervix (<em>n</em> = 2), lung (<em>n</em> = 2), breast, parotid gland (<em>n</em> = 2), esophagus, bile duct, stomach, meningioma, osteosarcoma, sarcoma (<em>n</em> = 2), melanoma. Tumor located in the following: the skull (<em>n</em> = 7), ribs (<em>n</em> = 7), vertebra (<em>n</em> = 6), pelvis (<em>n</em> = 3), and sternum (<em>n</em> = 2). The technical success rate and complications of ablation were recorded. Pain severity and functional state were evaluated by Numerical Rating Scale (NRS) and Oswestry Disability Index (ODI) before, 1 day, 1 month, 3 months, and 6 months after ablation.

Results:
The technical success rate was 100%. No severe complications occurred during and after ablation. The NRS scores before and, 1 day, 1 month, 3 months and 6 months after ablation were 6.7 ± 1.1, 2.9 ± 0.4, 3.0 ± 0.6, 3.0 ± 0.6 and 3.3 ± 0.8, respectively. The NRS scores at all time points after ablation were lower than those before ablation (<em>F</em> = 389.92, <em>P</em> < 0.01), but there was no significant difference at all time points after ablation (<em>P</em> > 0.05). ODI scores before and, 1 day, 1 month, 3 months and 6 months after ablation were 48.6 ± 15.8, 25.7 ± 11.6, 26.3 ± 10.9, 26.6 ± 11.1, 27.1 ± 11.6, respectively. ODI scores at all time points after ablation were lower than those before ablation (<em>F</em> = 175.16, <em>P</em> < 0.01), but there was no significant difference at all time points after ablation (<em>P</em> > 0.05). The median follow-up time was 8 months (range: 7-12 months). During the follow-up period, three patients had local recurrence at 3 months, 3 months, and 6 months after surgery, respectively. Four patients died within 1 year after surgery.

Conclusion:
MWA can provide short - to medium-term pain relief and functional improvement for patients with bone tumors, which is helpful to improve patients' quality of life. Further studies with more patients and longer follow-up period are needed to confirm the findings.