经皮椎体成形术联合放射治疗椎体转移瘤

目的探讨经皮椎体成形术(PVP)联合放射治疗对椎体转移瘤的临床应用价值。方法将66例椎体转移瘤分为3组,放射治疗组(放疗组)21例,总辐射剂量为30Gy,分10次于2周内完成;PVP治疗组(PVP组)20例,骨水泥粉液比例为1∶1,灌注量为胸椎2~5ml,腰椎为3~6ml;PVP联合放射治疗组(联合组)25例,PVP后第3~4天开始放疗。结果对所有病例均按既定计划完成治疗。治疗后1天及1、3、6个月,联合组疼痛完全缓解和显著缓解率均高于放疗组和PVP组,疼痛缓解快速、持续时间长。结论经皮椎体成形术联合放疗治疗椎体转移瘤在疼痛缓解、防止椎体塌陷及压缩性骨折等方面具有显著优势,疗效肯定且严重并发症少。

Percutaneous vertebraplasty combined with radiotherapy in treatment of spinal vertebra metastases

Objective To observe curative efficacy of percutaneous vertebroplasty （PVP） combined with radiotherapy for spinal vertebra metastases. Methods Totally 66 patients with spinal vertebra metastases were enrolled, including 21 cases underwent irradiation （dosage of 30 Gy/10f/2 weeks, irradiation group）, 20 underwent PVP （PVP group, the bone cement was made according to the ratio power/liquid contrast as 1：1 in injecting paste form, of thoracic spine using 2-5 ml, of lumbar spine using 3-6 ml）, as well as 25 cases underwent PVP combined with radiotherapy （combined group）, and the latter was performed 3-4 days after PVP. Results Treatment plans were successfully completed in all patients. One day, 1 month, 3 months and 6 months after treatment, the rate of completely relieve and significantly relieve were both significantly higher, and pain relief in combined group was quick and last longer in combined group than in the other two groups. Conclusion PVP combined with radiotherapy has definite therapeutic effect on spinal metastases in pain relieve and preventing vertebral body collapse and compression fracture without serious complications.