经皮椎体成形术联合缓释氟尿嘧啶治疗椎体转移瘤

目的 评估经皮椎体成形术(PVP)联合缓释氟尿嘧啶治疗椎体转移瘤的疗效及安全性.方法 入选椎体转移瘤患者共72例.其中PVP+缓释氟尿嘧啶组37例,单纯PVP 35例,通过临床症状、生存分析及影像学评估疗效及安全性.结果 PVP+缓释氟尿嘧啶组椎体肿瘤局部控制率67.6%(25,37),疼痛缓解率达89.2%(33,37);单纯PVP组椎体肿瘤局部控制率42.9%(15,35),疼痛缓解率85.7%(30/35),两组间局部肿瘤控制率差异有统计学意义(P=0.035).两组病例的生活质量、疼痛缓解及生存期差异无统计学意义(P值分别为0.124、0.462和0.498).结论 经皮椎体成形术联合缓释氟尿嘧啶治疗椎体转移瘤是安全、有效的新方法.可明显缓解晚期恶性肿瘤椎体转移带来的剧烈疼痛,改善患者生存质量,并对椎体转移病灶具有一定控制作用.

Percutaneous vertebroplasty combined with sustained - release fluorouracil for the treatment of vertebral metastasis tumor

Objective To evaluate the efficacy and safety of percutaneous vertebroplasty (PVP) combined with sustained-release fluorouracil for the treatment of vertebral metastasis tumor. Methods A total of 72 cases with vertebral metastasis tumor were enrolled in the study. Thirty-seven cases underwent percutaneous vertebroplasty combined with sustained -release fluorouracil, 35 underwent percutaneous vertebroplasty alone. Efficacy and safety were evaluated through clinical symptoms, survival analysis and radiology. Results Local tumor control and pain relief were achieved in 67.6% (25/37) and 89.2% (33/37) of the patients treated by percutaneous vertebroplasty combined with sustained-release fluorouracil combined, in 42.9% (15/35) and 85.7% (30/35) of those treated with percutaneous vertebroplasty alone. Significant difference was found between two groups for the local tumor control rate (P=0.035), but not for the quality of life, pain relief and survival (P=0.124, 0.462, 0.498, respectively). Conclusions The new treatment using percutaneous vertebroplasty combined with sustained-release fluorouracil for vertebral metastases is safe and effective, which substantially relieves the severe pain in patient with advanced vertebral invasion, and also improves the quality of life and oncological control.