经皮椎体成形术联合<sup>125</sup>I粒子植入治疗累及附件的胸腰椎转移瘤-东南大学学报医学版

经皮椎体成形术联合¹²⁵I粒子植入治疗累及附件的胸腰椎转移瘤

单位：1. 东南大学医学院, 江苏南京 210009;
2. 东南大学附属中大医院介入与血管外科, 江苏南京 210009

分类号：R817.58;R738.1

出版年·卷·期（页码）：2016·35·第五期（683-687）

摘要：

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）mCi。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 and ¹²⁵I 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) mCi. 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 and ¹²⁵I seed implantation can relief pain and improve quality of life safely and effectively.

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