Sun F H, He S C, Zhu H D, Fang W, Du R J, Li S S, Guo J H, Deng G, Qin Y L, Zhu G Y, Teng G J
Department of Radiology, the Affiliated Zhongda Hospital, Southeast University, Nanjing 210009, China.
Zhonghua Yi Xue Za Zhi. 2018 Sep 4;98(33):2661-2665. doi: 10.3760/cma.j.issn.0376-2491.2018.33.010.
To evaluate the effectiveness of cement augmentation on the osteolytic lesion in patients with vertebral metastasis. A total of consecutive 132 patients with 268 vertebral metastatic lesions treated with PVP from January 2008 to December 2016 in Zhongda Hospital were enrolled in this study. Retrospective analysis of preoperative, postoperative 3 days, 3 months, 6 months, 12 months and ≥ 18 months imaging data on CT, the local control and progression of the tumor were evaluated by MDA response criteria. The local control rates were compared between the groups with the different rate of cement filling by -test. Vertebroplasty procedures were performed successfully in all 268 vertebrae under DSA guidance, and the mean volume of PMMA injected in each vertebra was 0.7-8.5(3.9±1.5)ml.The rate of local control at 3 months, 6 months, 12 months and ≥18 months after PVP was respectively 98.9%, 95.1%, 91.8%, and 85.2%, the difference was statistically significant(all <0.05). The local control rate showed a statistically significant relationship to the groups with the rate of cement filling at 6 months, 12 months and ≥18 months after PVP, but there was no statistical difference at postoperative 3 months. The rate of local control was higher in 68 patients with lung or gastrointestinal cancer than in 17 patients with liver or kidney cancer at 3 months, 6 months and 12 months, the difference was statistically significant (<0.05). Cement augmentation has a local anti-tumor effect on vertebral osteolytic metastatic lesion, and the anti-tumor effect will decrease as the follow-up time extended.
评估骨水泥强化对椎体转移瘤患者溶骨性病变的疗效。选取2008年1月至2016年12月在中大医院接受经皮椎体成形术（PVP）治疗的132例连续患者，共268个椎体转移瘤病灶纳入本研究。回顾性分析术前、术后3天、3个月、6个月、12个月及≥18个月的CT影像资料，采用改良实体瘤疗效评价标准（MDA）评估肿瘤的局部控制情况及进展。通过t检验比较不同骨水泥填充率组间的局部控制率。所有268个椎体均在DSA引导下成功完成椎体成形术，每个椎体注入聚甲基丙烯酸甲酯（PMMA）的平均体积为0.7 - 8.5（3.9±1.5）ml。PVP术后3个月、6个月、12个月及≥18个月的局部控制率分别为98.9%、95.1%、91.8%和85.2%，差异有统计学意义（均P<0.05）。PVP术后6个月、12个月及≥18个月时，局部控制率与骨水泥填充率组间存在统计学差异，但术后3个月无统计学差异。在3个月、6个月和12个月时，68例肺癌或胃肠道癌患者的局部控制率高于17例肝癌或肾癌患者，差异有统计学意义（P<0.05）。骨水泥强化对椎体溶骨性转移瘤有局部抗肿瘤作用，且抗肿瘤作用会随着随访时间延长而降低。
