基于PET-CT的Tomita评分在脊柱转移瘤患者生存周期预测中的应用

Value of Tomita score based on PET/CT to predict survival time in patient with spinal metastases

目的探讨应用PET-CT检查进行Tomita评分的可行性,验证Tomita评分在脊柱转移瘤患者生存时间预测中的作用。方法回顾性分析2013年4月～2017年12月我院收治的脊柱转移瘤患者74例,其中男40例、女34例,年龄33～83岁。根据Tomita评分进行分组。A组(2～3分)11例,2例行广泛切除,9例非手术治疗;B组(4～5分)10例,3例行边缘切除,7例非手术治疗;C组(6～7分)15例,3例行姑息手术,12例非手术治疗;D组(8～10分)38例,2例行姑息手术,36例非手术治疗。对4组脊柱转移瘤患者的生存时间进行统计分析。结果随访2～46月,平均14.7月。患者平均生存时间13.0月:A组23.4月、B组16.3月、C组18.5月、D组7.0月。患者中位生存时间11月:A组21月、B组15月、C组13月、D组6月。Spearman相关性分析结果显示,患者的生存时间与Tomita评分呈负相关,Tomita评分越低,患者生存时间越长,临床预后越好(r=-0.6520,P<0.05)。结论应用PET-CT进行Tomita评分预测脊柱转移癌患者的生存时间具有可行性,Tomita评分越低,患者生存时间越长,具有方便、准确性高的优点。

Objective To explore the value of Tomita score to predict survival time in patients with spinal metastases.Methods We retrospectively collected 74 patients with spinal metastases from April 2013 to December 2017.The patients included 40 male and 34 female,the average age was 57.6 years old.The patients were divided into 4 groups according to Tomita score.Group A: Tomita score 2-3,included 11 patients,2 operate/9 nonoperate.Group B: Tomita score 4-5,included 10 patients,2 operate/9 nonoperate.Group C: Tomita score 6-7,included 15 patients,5 operate/10 nonoperate.Group D: Tomita score 8-10,included 38 patients,2 operate/36 nonoperate.The survival time and survival rate between the 4 groups were compared.Results The patients were followed up for 2-46 months(14.7 months on avaerage).The average survival time was 13.0 months:23.4 months of Group A,16.3 months of Group B,18.5 months of Group C,7.0 months of Group D.The median survival time was 11 months: 21 months of Group A,15 months of Group B,13 months of Group C,6 months of Group D.The survival time was negatively correlated with Tomita score.Tomita score was lower,while the survival time was longer(r =- 0.6520,P<0.05).Conclusion It is feasibile for PET-CT to grade Tomita score.It can be used easily and accurately to predict the survival time of the patients with spinal metastases.