Qi Lei, Li Chuankun, Wang Ning, Lian Haiping, Lian Minxue, He Baixiang, Bao Gang
Department of neurosurgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Medicine (Baltimore). 2018 Jan;97(3):e9575. doi: 10.1097/MD.0000000000009575.
To evaluate the function of percutaneous vertebroplasty (PVP) treatment to pain relief and life quality for patients with spinal tumors.
Articles about the researches on the treatment of spinal tumors by PVP in PubMed, Embase, and the Chinese Biomedical Literature database from January 1, 2015 to December 31, 2013. The keywords "spinal tumors," "efficacy," and "vertebroplasty" were firstly scanned to exclude all irrelevant articles. Then, the final inclusion of studies was determined by reading the full text of the remaining articles. The citation lists of all retrieved articles were scanned to identify other potentially relevant reports. RevMan5.2 was used to analyze pain intensity visual analog scale (VAS) and Karnofsky performance scores (KPS) within each research. Combined HRs (hazard ratio) were calculated using fixed- or random- effects models according to the heterogeneity.
Twenty-six studies involving 1351 patients met our selection criteria. Meta-analysis results among 10 case-control studies showed that the combined HR was -2.83 [95% confidence interval (CI) -2.92, -2.73; P < .0001], indicating a 2.83-fold decrease of pain in PVP group. For 12 single-arm studies, a significantly decrease of pain after PVP treatment (HR = -4.79, 95% CI -5.00, -4.57, P < .0001) was also found in PVP group. In addition, for KPS analysis, the combined HR was 16.31 (95% CI 14.31, 18.31; P < .0001), which indicated that PVP treatment was associated with a 16.31-fold increase of KPS. The combined HR was 0.58 (95% CI 0.35, 0.96; P = .04) for complication analysis.
PVP treatment of spinal tumor is significantly associated with better pain relief and life quality, which could improve the outcome in metastatic spinal tumor patients.
评估经皮椎体成形术(PVP)治疗对脊柱肿瘤患者疼痛缓解及生活质量的作用。
检索PubMed、Embase及中国生物医学文献数据库中2013年1月1日至2015年12月31日期间关于PVP治疗脊柱肿瘤的研究文章。首先扫描关键词“脊柱肿瘤”“疗效”和“椎体成形术”以排除所有不相关文章。然后,通过阅读剩余文章的全文确定最终纳入的研究。扫描所有检索文章的参考文献列表以识别其他潜在相关报告。使用RevMan5.2分析每项研究中的疼痛强度视觉模拟量表(VAS)和卡氏功能状态评分(KPS)。根据异质性,使用固定效应或随机效应模型计算合并风险比(HR)。
26项涉及1351例患者的研究符合我们的纳入标准。10项病例对照研究的Meta分析结果显示,合并HR为-2.83[95%置信区间(CI)-2.92,-2.73;P <.0001],表明PVP组疼痛降低了2.83倍。对于12项单臂研究,PVP组在PVP治疗后疼痛也显著降低(HR = -4.79,95% CI -5.00,-4.57,P <.0001)。此外,对于KPS分析而言,合并HR为16.31(95% CI 14.31,18.31;P <.0001),这表明PVP治疗与KPS升高16.31倍相关。并发症分析的合并HR为0.58(95% CI 0.35,0.96;P = 0.04)。
PVP治疗脊柱肿瘤与更好的疼痛缓解及生活质量显著相关,可改善转移性脊柱肿瘤患者的预后。