调强放疗与手术治疗椎体转移瘤的疗效分析

Analysis of the effect of IMRT and operation on vertebral metastasis

目的:本研究探讨椎体转移瘤治疗中应用调强放疗和外科手术的临床效果。方法:回顾性分析2018-05-2019-04我院接受治疗的单椎体转移瘤患者60例,根据其治疗方案将其分为A组(n=20)、B组(n=20)和C组(n=20),A组实施单纯外科手术、B组实施单纯调强放疗、C组实施调强放疗与外科手术联合治疗方案。结果:A组治疗有效率为75%(15/20),B组为55%(11/20),C组为90%(18/20),C组最高,B组其次,A组最低(P<0.05);A组、B组和C组治疗3个月后复发率分别为25%(5/20)、10%(1/20)、5%(1/20),A组最高C组最低(P<0.05);A组、B组和C组治疗6个月后复发率分别为60%(12/20)、25%(15/20)、15%(13/20),A组最高C组最低(P<0.05)。B组照射剂量为(44.92±3.95)Gy、C组照射剂量为(57.31±4.27)Gy,C组较高(P<0.05)。结论:调强放疗与手术治疗联合使用可提高椎体转移瘤治疗效果,同时提高肿瘤放疗时照射剂量,达到提高根治率降低复发率的目的。

OBJECTIVE To explore the clinical effect of IMRT and surgery in the treatment of vertebral metastasis.METHODS A retrospective analysis was made of 60 patients with single vertebral metastasis who were treated in our hospital from May 2018 to April 2019.According to the treatment plan,they were divided into group A(n=20),group B(n=20)and group C(n=20),Group a received surgery alone,group B received IMRT alone,and group C received IMRT combined with surgery.RESULTS The effective rate was 75%(15/20)in group A,55%(11/20)in group B,90%(18/20)in group C,the highest in group C,the second in group B and the lowest in group A(P<0.05);The recurrence rate of group A,group B and group C was 25%(5/20),10%(1/20)and 5%(1/20),respectively,the highest in group A and the lowest in group C(P<0.05);The recurrence rates of group A,group B and group C were 60%(12/20),25%(15/20)and 15%(13/20)after six months of treatment,respectively,the highest in group A and the lowest in group C(P<0.05).The dose of group B was(44.92±3.95)gy,group C was(57.31±4.27)gy,group C was higher(P<0.05).CONCLUSION The combination of IMRT and surgical treatment can improve the therapeutic effect of vertebral metastasis,increase the dose of radiotherapy,and achieve the purpose of improving the radical rate and reducing the recurrence rate.