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.