Objective To study the effect of CT-guided percutaneous vertebroplasty (PVP) combined with 125Ⅰseed implantation and traditional conventional radiotherapy on local spinal metastatic tumor. Methods Sixty-nine patients with spinal metastatic tumor admitted to our hospital from February 2011 to October 2012 were divided into group A (n=36) and group B (n=33). Patients in group A were treated with PVP combined with 125Ⅰseed implantation and those in group B underwent conventional radiotherapy. The local reaction, pain relief and vertebral body collapse were compared between the two groups after treatment. Results All the patients completed the planned treatment. The CR, PR, SD, and PD were 0%, 88.9%, 11.1%, 0%respectively in group A and 0%, 60.6%, 21.2%, 18.2%respectively in group B 3 months after treatment. The clinical beneficial rate was 100%and 81.8%respectively in the two groups. The pain relief rate was 88.9%, 87.7%, 95.9%respectively in group A and 0%, 27.3%, 54.5%respectively in group B 1 day, 1 and 3 months after treatment. The incidence of aggravated vertebral body collapse and new compression fractures was significantly lower in group A than in group B (2.8%vs 30.3%, P<0.05). Bone cement leakage into the adjacent dural sac and the soft tissues along the needle path was found in 1 and 2 patients of group A respectively with no significant symptom during the follow-up. Gastrointestinal symptoms such as nausea and vomiting occurred in group B. Conclusion CT-guided PVP combined with 125Ⅰseed implantation has a definite effect on spinal metastatic tumor and is more effective than conventional radiotherapy in relieving pain, preventing vertebral body collapse and compression fracture. It is thus a safe and reliabe minimally invasive treatment modality for local spinal metastatic tumor.% 目的探讨CT引导下经皮椎体成形术(percutaneous vertebro-plasty，PVP)联合125Ⅰ放射性粒子植入技术与传统放疗局部治疗对脊柱转移瘤的疗效。方法将我院2011年2月-2012年10月收治的69例脊柱转移性肿瘤患者分为两组，A组36例采用PVP联合125Ⅰ粒子植入治疗，B组33例接受传统放射治疗，比较两组治疗后的局部反应、疼痛缓解及治疗部位椎体塌陷情况。结果所有患者均按既定计划完成治疗，治疗后3个月完全缓解(CR)、部分缓解(PR)、疾病稳定(SD)、疾病进展(PD)，A组分别为0%、88.9%、11.1%、0%，B组为0%、60.6%、21.2%、18.2%，两组临床获益率分别为100%和81.8%；术后1 d、1月、3月的疼痛缓解率A组分别为88.9%、87.7%、95.9%，B组为0%、27.3%、54.5%；A组治疗部位椎体塌陷加重或发生新的压缩性骨折的比率较B组明显降低(2.8%和30.3%，P＜0.05)。A组1例骨水泥渗漏至硬膜囊附近，2例骨水泥沿进针路径渗漏至软组织内，随访中均未见明显临床症状；B组部分患者出现恶心、呕吐等胃肠道症状。结论 CT引导下PVP联合放射性125Ⅰ粒子植入技术治疗脊柱转移瘤疗效确切。与传统放疗相比，在疼痛的缓解、预防椎体塌陷及压缩性骨折等方面有明显优势，是一种安全可靠的局部微创治疗方法。
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