^(89)Sr核素治疗联合椎体成形术或放疗治疗椎体转移癌

The effects of combination of ^(89)Sr radionuclide therapy and vertebroplasty or radiotherapy in treatment of spinal vertebra metastases

目的:探讨^(89)Sr核素联合经皮椎体成形术(PVP)或放疗治疗椎体转移癌的临床疗效及应用价值。方法:77例确诊恶性肿瘤椎体转移的患者随机分为3组:放疗组,^(89)Sr+放疗组,^(89)Sr+PVP组。评价治疗后的骨痛缓解、体力状态改善、转移灶疗效、生化指标及不良反应。结果:三组患者均顺利完成治疗,其中^(89)Sr联合治疗组的疼痛缓解率优于放疗组,但差异无统计学意义(P>0.05)。体力状态改善率也优于放疗组,特别是^(89)Sr+PVP组差异有统计学意义(P<0.05)。^(89)Sr联合治疗组的病灶好转率均优于放疗组,差异均有统计学意义(P<0.05)。^(89)Sr联合治疗组的血清碱性磷酸酶及血钙水平较放疗组明显下降,差异有统计学意义(P<0.05)。结论:^(89)Sr核素联合PVP或放疗治疗椎体转移癌可优势互补,具有良好的临床疗效,为椎体转移癌的治疗提供了新的临床思路。

Objective：To investigate the clinical effects and application value of ^（89）Sr radionuclide therapy combined with percutaneous vertebroplasty（PVP） or radiotherapy in treatment of spinal vertebra metastases.Methods：All 77 cases of spinal vertebra metastases patients were randomly divided into 3 groups：Radiotherapy group,^（89）Sr＋radiotherapy group,^（89）Sr＋PVP group.Bone pain palliation physical performance improvement,bone metastasis lesions improvement,biochemical indicators and side effects were evaluated after.Results：All cases completed treatment successfully.The pain-relief rate of ^（89）Sr combination group was higher than that of radiation group,but the difference had no statistical insignificance（P〈0.05）.The performance-improvement rate of ^（89）Sr combination groups was higher than that of radiation group,especially in ^（89）Sr＋PVP group with a statistical insignificance（P〉0.05）.The metastasis- lesions- improvement rate of Sr combination groups was higher than that of radiation group with statistical insignificances（P〈0.05）.Level of serum alkaline phosphatase and calcium of ^（89）Sr combination group was lower than that of radiation group with a statistical insignificance（P〈0.05）.Conclusion：Combination of ^（89）Sr radionuclide therapy and vertebroplasty or radiotherapy in treatment of spinal vertebra metastases has complementary advantages and good clinical effects,and provides new clinical ideas.