Qian Jiale, Bao Zhaohua, Zou Jun, Yang Huilin
Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China.
J Pain Res. 2016 May 10;9:271-8. doi: 10.2147/JPR.S105284. eCollection 2016.
The aim of this study was to investigate the clinical efficacy of pedicle fixation combined with (125)I brachytherapy in treating metastatic thoracolumbar tumors.
A retrospective analysis of the clinical data of seven metastatic thoracolumbar tumor patients who received pedicle fixation combined with radioactive (125)I seed implantation brachytherapy in our department between January 2009 and December 2013 was performed. The visual analog scale (VAS) for pain and the Karnofsky performance status (KPS) score before the operation and 1, 6, and 12 months after the operation were observed and recorded. The changes in the scores at each time point were compared.
All the patients underwent a successful operation, without any complications during their hospitalization. All the patients received postoperative follow-up, and the duration of follow-up was 15-50 months, with an average of 32.2 months. One pancreatic cancer patient died of liver failure and hypoproteinemia 28 months post surgery. The VAS scores of patients before the operation and 1, 6, and 12 months after the operation were 7.43±0.98, 2.71±0.49, 3.00±0.82, and 4.29±0.98, respectively; the KPS scores were 52.9±9.5, 84.3±5.3, 75.7±5.3, and 72.9±4.9, respectively. These results suggest that the VAS score at each time point was significantly decreased compared with that before the operation, while the KPS score was significantly increased compared with that before the operation. Both differences had statistical significance (P<0.05).
As a therapy for advanced malignant tumors with thoracolumbar metastasis, pedicle fixation combined with (125)I brachytherapy can effectively relieve short-term pain and improve patient's quality of life.
本研究旨在探讨椎弓根内固定联合¹²⁵I近距离放射治疗转移性胸腰椎肿瘤的临床疗效。
对2009年1月至2013年12月期间在我科接受椎弓根内固定联合放射性¹²⁵I粒子植入近距离放射治疗的7例转移性胸腰椎肿瘤患者的临床资料进行回顾性分析。观察并记录术前及术后1、6、12个月的视觉模拟疼痛评分（VAS）和卡氏功能状态评分（KPS）。比较各时间点评分的变化。
所有患者手术均获成功，住院期间无任何并发症。所有患者均接受术后随访，随访时间为15 - 50个月，平均32.2个月。1例胰腺癌患者术后28个月死于肝衰竭和低蛋白血症。患者术前及术后1、6、12个月的VAS评分分别为7.43±0.98、2.71±0.49、3.00±0.82和4.29±0.98；KPS评分分别为52.9±9.5、84.3±5.3、75.7±5.3和72.9±4.9。结果表明，各时间点的VAS评分与术前相比均显著降低，而KPS评分与术前相比显著升高。差异均有统计学意义（P<0.05）。
作为一种治疗胸腰椎转移的晚期恶性肿瘤的方法，椎弓根内固定联合¹²⁵I近距离放射治疗可有效缓解短期疼痛并提高患者生活质量。
