Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Int J Hyperthermia. 2023;40(1):2241687. doi: 10.1080/02656736.2023.2241687.
To compare the clinical efficacy of percutaneous vertebroplasty (PVP) alone and microwave ablation (MWA) combined with PVP for the treatment of painful spinal metastases from non-small cell lung cancer (NSCLC).
From October 2014 to October 2021, the data of 58 NSCLC patients with refractory painful spinal metastases (visual analog scale score ≥ 5) were retrospectively collected and analyzed. Patients in Group A ( = 30) and Group B ( = 28) received PVP alone and MWA combined with PVP, respectively. The primary endpoint was pain relief. The secondary endpoints were quality of life (QoL), local tumor progression (LTP), and complications.
The technical success rate was 100% in both groups. Patients in both groups showed similar pain relief at 1-12 weeks, but patients in Group B still showed sustained pain relief at 24 weeks compared to those in Group A ( = 0.03). The assessment of QoL showed similar changes. LTP (33.00% vs. 7.14%, = 0.02) and cement leakage rates (40.00% vs. 7.14%, = 0.03) were lower in Group B. The multivariate analysis demonstrated spinal metastases with a maximum diameter ≤ 3.0 cm ( = 0.027) and MWA combined with PVP ( = 0.028) were two independent protective factors for LTP. For cement leakage, spinal metastases with vertebral body compression ( = 0.019) was an independent risk factor, while MWA combined with PVP ( = 0.042) was an independent protective factor.
MWA combined with PVP for painful spinal metastases from NSCLC performed more sustained pain relief (>6 months) and ultimately improved QoL with lower LTP and cement leakage rates, compared to PVP alone.
比较单纯经皮椎体成形术（PVP）与微波消融（MWA）联合 PVP 治疗非小细胞肺癌（NSCLC）所致疼痛性脊柱转移的临床疗效。
回顾性收集 2014 年 10 月至 2021 年 10 月 58 例 NSCLC 伴难治性疼痛性脊柱转移（视觉模拟评分≥5）患者的资料，分为 A 组（n=30）和 B 组（n=28），分别接受单纯 PVP 和 MWA 联合 PVP 治疗。主要终点为疼痛缓解。次要终点为生活质量（QoL）、局部肿瘤进展（LTP）和并发症。
两组技术成功率均为 100%。两组患者在 1-12 周时疼痛缓解情况相似，但 B 组患者在 24 周时仍保持持续缓解（P=0.03）。QoL 评估也有相似的变化。LTP（33.00% vs. 7.14%，P=0.02）和骨水泥渗漏率（40.00% vs. 7.14%，P=0.03）均较低。多因素分析显示，脊柱转移瘤最大直径≤3.0cm（P=0.027）和 MWA 联合 PVP（P=0.028）是 LTP 的两个独立保护因素。对于骨水泥渗漏，椎体压缩性脊柱转移（P=0.019）是独立的危险因素，而 MWA 联合 PVP（P=0.042）是独立的保护因素。
与单纯 PVP 相比，MWA 联合 PVP 治疗 NSCLC 所致疼痛性脊柱转移瘤可获得更持久的疼痛缓解（>6 个月），最终提高 QoL，LTP 和骨水泥渗漏率较低。
