Therapeutic effect of percutaneous vertebroplasty combined with intensity-modulated radiation therapy for spinal metastases
10.13929/j.1672-8475.201903035
- Author:
Jianye SUN
1
Author Information
1. Department of Oncology, Changle People's Hospital
- Publication Type:Journal Article
- Keywords:
Bone cement;
Neoplasm metastasis;
Percutaneous vertebroplasty;
Radiotherapy;
Spine
- From:
Chinese Journal of Interventional Imaging and Therapy
2019;16(11):676-681
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the efficacy of percutaneous vertebroplasty (PVP) combined with intensity modulated radiation therapy (IMRT) for spinal vertebra metastases. Methods: Data of 106 patients with spinal metastases were retrospectively analyzed, including 38 patients underwent PVP combined with IMRT(PVP+IMRT group), 38 received PVP (PVP group) and 30 received IMRT (IMRT group). The pain visual analogue scale (VAS), tumors of spine instability score (SINS) and Karnofsky performance status score (KPS) were used to evaluate pain, spinal stability improvement and functional status. The adverse reaction and local progression were also observed. Kaplan-Meier was used to analyze the survival analysis, while Cox proportional hazard model was used to evaluate the correlations of survival and clinical factors. Results: There was no significant difference of local tumor progression among 3 groups 6 months after treatment (χ2=5.890, P=0.061). VAS were significant different among 3 groups 1 month, 3 months, 6 months and 12 months after treatment (all P<0.05), which in PVP+IMRT group was significantly lower than in IMRT group (both P<0.016 7). Significant intragroup differences after and before treatment were observed in all 3 groups (all P<0.016 7). Intragroup differences of KPS scores were noticed in PVP+IMRT and PVP groups before and after treatment (P=0.007, 0.033), also before and 3 months after treatment (both P<0.016 7). There were statistically significant differences of SINS among 3 groups 1 and 3 months after treatment, also between PVP+IMRT and PVP group (P<0.016 7). There was no significant difference of overall survival rate among 3 groups (P>0.05). Brain or visceral metastasis, KPS and the medical treatment were independent factors affecting prognosis. Conclusion: PVP combined with IMRT for spinal metastases is good at relieving pain, maintaining the stability of vertebral body and improving the functional status.
