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经皮骨水泥成形术在多发性骨髓瘤中的应用:疼痛控制和维持行走能力的重要辅助手段

Percutaneous cementoplasty in multiple myeloma: a valuable adjunct for pain control and ambulation maintenance.

作者信息

Tran Thang Nhu Nam, Abdo German, Martin Jean-Baptiste, Seium-Neberay Yodit, Yilmaz Hasan, Verbist Marie-Christine, Rufenacht Daniel, Sappino Andre-Pascal, Dietrich Pierre-Yves

机构信息

Division of Oncology, Geneva University Hospital, 21 rue Micheli-du-Crest, 1211, Geneva 14, Switzerland.

出版信息

Support Care Cancer. 2008 Aug;16(8):891-6. doi: 10.1007/s00520-007-0344-6. Epub 2007 Oct 25.

Abstract

GOALS OF WORK

Bone pain and functional impairment are major concerns for multiple myeloma (MM) patients. The goal of this study was to better define the role of percutaneous cementoplasty (PC) in improving their quality of life.

MATERIALS AND METHODS

This retrospective analysis included 28 consecutive heavily pretreated MM patients managed at our institution between 1996 and 2002. They underwent a total of 34 PC procedures for the treatment of 117 vertebrae and 2 iliac sites and were evaluated at 1 month.

MAIN RESULTS

Significant pain reduction of >50% was obtained after 83% of the procedures, with a mean visual analogous score decreasing from 7.48/10 to 2.1/10 (p < 0.001). It resulted in a complete interruption of opiate analgesic consumption after 59.3% of the procedures, with a mean decrease of 70.4% in the opiate dose. Functional impairment was evaluated with the Eastern Cooperative Oncology Group (ECOG) performance status scale, with mean scores improving from 1.9 to 0.86 after the procedures (p = 0.001). There was no major complication.

CONCLUSION

PC is a safe, feasible, and efficient approach for the treatment of bone pain and disability in MM patients.

摘要

工作目标

骨痛和功能障碍是多发性骨髓瘤(MM)患者的主要担忧。本研究的目的是更好地界定经皮骨水泥成形术(PC)在改善其生活质量方面的作用。

材料与方法

这项回顾性分析纳入了1996年至2002年在我们机构接受治疗的28例连续的经过大量预处理的MM患者。他们总共接受了34次PC手术,用于治疗117个椎体和2个髂骨部位,并在1个月时进行了评估。

主要结果

83%的手术术后疼痛显著减轻>50%,视觉模拟评分平均从7.48/10降至2.1/10(p<0.001)。59.3%的手术术后完全停止使用阿片类镇痛药,阿片类药物剂量平均减少70.4%。采用东部肿瘤协作组(ECOG)功能状态量表评估功能障碍,术后平均评分从1.9提高到0.86(p=0.001)。无重大并发症。

结论

PC是治疗MM患者骨痛和残疾的一种安全、可行且有效的方法。

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