For Doctors
All the information about FURTHER Project for medical professionals
Rationale
Why is project FURTHER important?
Pain palliation options
Radiotherapy, MR-HIFU or both?
Relevant literature
About MR-HIFU for bone metastases.
Cancer induced bone pain as a result of bone metastases strongly interferes with quality of life and daily functioning of patients with advanced cancer. The current standard of care for patients with painful bone metastasis includes palliative external beam radiotherapy (EBRT). While EBRT is a well-established treatment option, it takes up to 4-6 weeks for EBRT to induce optimal pain relief, and 30-40% of patients do not respond to EBRT.
Pain palliation may be substantially improved by including magnetic resonance image guided high intensity focused ultrasound (MR-HIFU) as alternative or in addition to EBRT. Until now, no studies have been conducted in which EBRT and MR-HIFU have been compared as a first-line treatment in patients with painful metastatic bone disease. Thus, strong evidence and context is lacking for wide-spread implementation of MR-HIFU into routine care.
Objective
The FURTHER study aims to provide the evidence base to stimulate the uptake of MR-HIFU as a first line treatment option in clinical guidelines for the treatment of cancer induced bone pain, by evaluating the effectiveness and cost-effectiveness of MR-HIFU (alone or in combination with EBRT) compared to standard-of-care as a palliative treatment option to relieve cancer induced bone pain.
For more information on the aim of the project, visit the about the project page.
The FURTHER study will be performed in male and female adult (≥ 18 years) cancer patients capable of giving informed consent, who were referred to the department of radiation oncology for treatment of painful bone metastases (pain score on Numerical Rating Scale (NRS) ≥ 4). Patients have to have a reasonable perfomance score and an estimated life expectancy of more than 3 months. The target bone metastasis has to be distinguishable and accessible for MR-HIFU and radiotherapy. Patients are not eligible if they had recent surgery on the target location, if there are unavoidable critical structures in the target area or if any contra indications for MRI or sedation are present.
In the clinical trial of the FURTHER project, three treatment strategies will be compared. Below you’ll find a short explanation of these treatment strategies.
