经皮椎体成型术携带药物介入治疗椎体转移瘤的临床研究

背景与目的:脊柱转移是癌症晚期患者的主要表现之一,现有的治疗方法较多但效果不佳。本研究旨在探讨经皮椎体成型术(percutaneousvertebroplasty,PVP)联合化疗药治疗椎体转移瘤的价值。方法:75例椎体转移瘤患者,其中39例43个椎体在CT定位下行PVP联合化疗药治疗(vertebroplastycombinedchemotherapy,VPCC),36例39个椎体行单纯PVP治疗(percutaneousvertebroplastyonly,VP)。通过疼痛调查表和定期随访观察疗效和并发症。结果:VPCC组有效率为93.0%,完全缓解率为25.6%;VP组有效率为74.4%,完全缓解率为10.3%。VPCC组主要术后并发症和不良反应为术后短时间疼痛加重。结论:PVP治疗椎体转移瘤可起到止痛和加固椎体的局部治疗作用,骨水泥中加入化疗药可提高PVP的短期疗效。

Treatment effect of percutaneous vertebroplasty combined with interventional chemotherapy on vertebral metastases

BACKGROUND & OBJECTIVE: Vertebral metastasis is a common manifestatio n of patients with advanced cancer without effective treatment. This study was t o explore treatment value and efficacy of percutaneous vertebroplasty (PVP) comb ined with interventional chemotherapy on vertebral metastases. METHODS: Seventy- five patients with vertebral metastases (42 men, 33 women; aged 31-76 years) wer e divided into 2 groups: 39 were treated by PVP combined with chemotherapy (VPCC group), and 36 were treated by PVP alone (VP group). All procedures were guided by CT scan. The results and complications were evaluated by pain questionnaire and routine follow-up. RESULTS: Response rate was significantly higher in VPCC g roup than in VP group (93.0% vs. 74.4%, P < 0.05); complete response rates of VP CC group and VP group were 25.6% and 10.3%. Common complication of VPCC was tran sient aggravation of pain. CONCLUSIONS: PVP may release the pain, and consolidat e the vertebrae of patients with vertebral metastases. Its short-term effect may be enhanced by adding drugs into bone cement.