经皮椎体成形术联合适形放射治疗椎体转移瘤的疗效观察

摘要

目的 探讨经皮椎体成形术(PVP)联合适形放射治疗椎体转移瘤的临床疗效.方法 回顾性分析椎体溶骨性转移瘤68例患者资料, A组38例接受PVP联合适形放射治疗方案, B组30例接受单纯适形放射治疗方案.比较治疗后两组患者疼痛缓解度、脊柱稳定改善度、体能状况及中位生存时间.采用疼痛视觉模拟评分(VAS)、脊柱肿瘤不稳定评分(SINS)、体能状况评分(KPS)对两组患者的疼痛、脊柱稳定改善度和体能状况进行评价;使用Kaplan-Meier法进行两组患者的生存分析.结果 A组患者治疗后l、3、6、12个月的VAS评分均明显低于B组, 差异有统计学意义(P＜0.05);A组患者治疗后1、3个月的脊柱SINS评分与B组比较差异有统计学意义(P＜0.05);体能状况评分(KPS)A组患者与B组比较治疗后1个月时差异无统计学意义(P＞0.05), 3个月时差异有统计学意义(P＜0.05);A组患者治疗后的中位生存时间与B组差异无统计学意义(P＞0.05).结论 对椎体转移瘤, PVP联合放射治疗比单纯放射治疗更能缓解患者的疼痛, 维持椎体的稳定性, 改善患者的生活质量, 值得推广.%Objective To evaluate the clinical effect of percutaneous vertebroplasty (PVP) combined with appropriate radiotherapy in the treatment of vertebral metastases. Methods We retrospectively analysed of 68 cases of vertebral osteolytic metastases treated in Department of Oncology, Changle people's Hospital, 2013-03-2015-09.Group A (38 cases) received PVP combined with conformal radiotherapy, group B (30 cases) received simple conformal radiotherapy regimen. The pain relief, spinal stability improvement, physical fitness and median survival time were compared between the two groups after treatment. The Pain visual analogue score (VAS), spinal tumor instability score (SINS), physical fitness score (KPS) was used to evaluate pain spinal stability improvement and physical fitness in two groups of patients. Survival analysis of two groups of patients using Kaplan-Meier method. Results The VAS scores in group A were significantly lower than those in group B at 1 month, 3 months, 6 months, and 12 months after surgery (P＜0.05). The spinal SINS scores in group A were significantly higher than that in group B at 1 and 3 months after treatment (P＜0.05). There was no significant difference in physical fitness score between (KPS) group A and group B at 1 month after treatment (P＞0.05), but there was significant difference at 3 months (P＜0.05). There was no significant difference in median survival time between group A and group B (P＞0.05). Conclusion For vertebral metastases, the combination of PVP and radiotherapy can relieve pain, maintain the stability of vertebral body, and improve the quality of life of patients, which is worth popularizing.