经皮椎体成形术联合^(125)I粒子植入治疗累及附件的胸腰椎转移瘤

Thoracolumbar vertebral metastasis involving appendix of vertebra treated by combination of percutaneous vertebroplasty and ^(125)I seeds implantation

目的:评估经皮椎体成形术(PVP)联合125I粒子植入治疗累及附件的胸腰椎转移瘤的疗效及安全性。方法:收集2014年7月至2015年6月我医院采用PVP联合125I植入疗法治疗累及附件的胸腰椎转移瘤患者。采用视觉模拟评分(VAS)及欧洲癌症研究与治疗组织生活质量核心30问卷(EORTC QLQ-C30)评估疗效。记录术前及术后1周、2个月、4个月、6个月的VAS及QLQ-C30评分,同时记录术后并发症,以评估疗效及安全性。结果:根据纳入及排除标准,共收集病例29例。每个椎体骨水泥平均注射量为(3.2±1.2)ml,每处附件转移灶粒子平均放射强度为(20.2±11.6)m Ci。平均随访(5.4±1.2)个月。术前及术后各时点的VAS分别为9.2±0.8、6.8±1.5、5.3±1.5、4.8±2.0、4.7±1.8(F=48.7,P<0.001);术前及术后各时点的QLQ-C30生活质量得分分别为11.3±8.6、24.4±13.8、41.1±15.9、42.9±19.8、44.1±16.5(F=29.8,P<0.001)。并发症仅见无症状骨水泥泄漏。结论:应用PVP联合125I粒子植入治疗累及附件的胸腰椎转移瘤,安全有效,可明显缓解患者疼痛,提高生活质量。

Objective： To assess the efficacy and safety of the combination of percutaneous vertebroplasty（ PVP）and ^125I seed implantation for thoracolumbar vertebral metastasis involving appendix of vertebra. Methods： An analysis was conducted on patients,who were treated with the combination of PVP and125 I seed implantation during the period from July 2014 to June 2015 in our hospital. Visual analogue scale and EORTC QLQ- C30 were determined to evaluate the therapeutic efficacy. VAS and QLQ-C30 score were calculated before the operation as well as 1 week,2,4 and 6 months after the operation. The complication also was collected. Results： 29 cases were collected according to the inclusion criteria and exclusion criteria. The mean amount of cement used for each diseased vertebral body was（ 3. 2 ± 1. 2） ml. The mean radiation dose for each diseased appendix was（ 20. 2 ±11. 6） m Ci. The patients were followed up for a mean of 5. 4 ± 1. 2 months. After results were analyzed,we found that preoperative and postoperative VAS were 9. 2 ± 0. 8,6. 8 ± 1. 5,5. 3 ± 1. 5,4. 8 ± 2. 0,4. 7 ± 1. 8（ F = 48. 7,P〈0. 001）,respectively; and that preoperative and postoperative EORTC QLQ-C30 were 11. 3 ± 8. 6,24. 4 ±13. 8,41. 1 ± 15. 9,42. 9 ± 19. 8,44. 1 ± 16. 5,respectively（ F = 29. 8,P〈0. 001）. The only complication was asymptomatic cement leakage. Conclusion： For the treatment of thoracolumbar vertebral metastasis involving appendix of vertebra,the combination of PVP and125 I seed implantation can relief pain and improve quality of life safely and effectively.