临床肿瘤学杂志

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椎体放射治疗脊柱转移瘤的临床疗效观察

肖智志1,刘 晖1,李 俐2,邓创伟3,徐振华4,陈 顺5,蔡 强6   

  1. 1 430064 武汉 武汉大学中南医院放化疗科2 430064 武汉大学中南医院产科3 430400 武汉市新洲区人民医院骨科4 430070 广州军区武汉总医院肿瘤科5 430064 武汉科技大学附属天佑医院肿瘤科6 430060 武汉大学人民医院神经外科
  • 收稿日期:2016-05-27 修回日期:2016-07-19 出版日期:2016-09-30 发布日期:2016-09-30
  • 通讯作者: 刘 晖

Clinical Observation of the effect of vertebral radiotherapy in the treatment of spinal metastasis

XIAO Zhizhi, LIU Hui, LI Li, DENG Chuangwei, XU Zhenhua, CHEN Shun, CAI Qiang.
  

  1. Department of Radiotherapy and Chemotherapy, Zhongnan Hospital of Wuhan University, Wuhan 430064, China
  • Received:2016-05-27 Revised:2016-07-19 Online:2016-09-30 Published:2016-09-30
  • Contact: LIU Hui

摘要: 目的 探讨椎体放射治疗脊柱转移瘤的临床疗效及安全性。方法 回顾性分析2012年9月至2016年2月116例脊柱转移瘤患者的临床病例资料,其中对照组58例,仅接受经皮椎体成形术;观察组58例接受经皮椎体成形术联合放疗(3 Gy/次,1次/天,5次/周,共4周)。观察两组的止痛有效率,术后第1天和术后4周椎体高度恢复率与Cobb角恢复率以及并发症的发生情况。结果 两组患者均顺利完成治疗。观察组的止痛有效率为93.1%,高于对照组的79.3% (P<0.05)。观察组术后4周椎体高度恢复率与Cobb角恢复率分别为(45.36±10.33)%和(45.96±10.45)%,高于对照组的(42.89±10.41)%和(41.99±8.22)% (P<0.05),且两组术后4周上述两项指标均显著高于术后第1天(P<0.05)。两组主要并发症为骨水泥外渗和下肢酸胀不适,观察组放疗不良反应轻微。结论 椎体放疗联合经皮椎体成形术治疗脊柱转移瘤能有效缓解疼痛,促进椎体畸形的纠正,安全性高,是一种值得推荐的治疗方法。

Abstract: Objective To investigate the clinical efficacy and safety of vertebral radiotherapy in the treatment of spinal metastasis. Methods The data of 116 spinal metastatic tumors patients from September 2012 to February 2016 were retrospectively reviewed. All the patients were equally divided into the observation group and the control group with 58 patients in each group according to treatment. Patients in control group were treated with percutaneous vertebral angioplasty,and those in observation group were given percutaneous vertebral angioplasty combined with radiotherapy (3 Gy/f, 1/d, 5/week, 4 weeks). Vertebral body height recovery rate and Cobb angle recovery rate were observed 1 day and 4 weeks after operation. Complications were recorded as well. Results All the patients accomplished treatment in plan. Pain relief rate in observation group was 93.1%, higher than 79.3% of control group (P<0.05). The vertebral body height recovery rate and Cobb angle recovery rate in observation group were (45.36±10.33)% and (45.96±10.45)%, higher than (42.89±10.41)% and (41.99±8.22)% of control group (P<0.05), and the two indexes were significantly higher 4 weeks after operation than those of 1 day after operation (P<0.05). The main complications of the two groups were bone cement leakage and discomfort of lower limbs, and the side effect of radiotherapy in observation group was mild. Conclusion Vertebral radiotherapy combined with percutaneous vertebral angioplasty in the treatment of spinal metastasis can effectively relieve pain, promote the correction of vertebral deformity with high safety, which is worth of clinical recommendation.

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