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多发性骨髓瘤患者化疗和放疗与化疗、放疗和多节段椎体成形术或后凸成形术的临床结局比较。

Clinical Outcome of Chemotherapy and Radiation Therapy Versus Chemotherapy, Radiation Therapy, and Multilevel Vertebroplasty or Kyphoplasty for Multiple Myeloma.

出版信息

Orthopedics. 2024 Jul-Aug;47(4):225-231. doi: 10.3928/01477447-20240325-06. Epub 2024 Apr 4.

Abstract

BACKGROUND

Vertebral augmentation including vertebroplasty and kyphoplasty may restore function without interfering with the therapeutic regimen of patients with multiple myeloma. We sought to evaluate the effects of adding multilevel vertebral augmentation to conventional therapy protocols for patients with multiple myeloma.

MATERIALS AND METHODS

Forty-four patients recently diagnosed with multiple myeloma were randomly assigned to two groups. One group received multilevel vertebral augmentation (kyphoplasty or vertebroplasty) in addition to conventional therapy (MVA), and the other group received conventional therapy alone (CTA). Patients were evaluated before treatment and at 3 months, 6 months, 1 year, 2 years, 3 years, 4 years, and 5 years after treatment by using the Oswestry Disability Index (ODI), the Stanford Score (SS), and the Spinal Instability Neoplastic Score (SINS).

RESULTS

The mean ODI, SS, and SINS were nearly equal before treatment, being 34.19 (68.38%), 4.58, and 12.30, respectively, for the MVA group and 32.29 (64.58%), 4.63, and 13.88, respectively, for the CTA group. There were significant differences in the ODI, SS, and SINS between the two groups at all follow-up intervals. The ODI and SINS were statistically significantly different between the two groups (=.020 and <.001, respectively). There was an insignificant difference in SS between the two groups.

CONCLUSION

This study found that performing kyphoplasty and vertebroplasty in addition to conventional therapy for patients with multiple myeloma resulted in enhanced morbidity and functional outcomes. [. 2024;47(4):225-231.].

摘要

背景

椎体强化术(包括椎体成形术和后凸成形术)可在不影响多发性骨髓瘤患者治疗方案的情况下恢复功能。我们旨在评估对多发性骨髓瘤患者在常规治疗方案基础上添加多节段椎体强化术的效果。

材料和方法

44 例近期被诊断为多发性骨髓瘤的患者被随机分配到两组。一组患者在常规治疗(CTA)的基础上接受多节段椎体强化术(后凸成形术或椎体成形术)(MVA),另一组仅接受常规治疗(CTA)。在治疗前以及治疗后 3 个月、6 个月、1 年、2 年、3 年、4 年和 5 年,通过 Oswestry 功能障碍指数(ODI)、斯坦福评分(SS)和脊柱不稳肿瘤评分(SINS)评估患者。

结果

在治疗前,两组的平均 ODI、SS 和 SINS 几乎相等,MVA 组分别为 34.19(68.38%)、4.58 和 12.30,CTA 组分别为 32.29(64.58%)、4.63 和 13.88。在所有随访间隔中,两组之间的 ODI、SS 和 SINS 均有显著差异。两组之间的 ODI 和 SINS 有统计学差异(分别为 =.020 和 <.001)。两组之间的 SS 无显著差异。

结论

本研究发现,在多发性骨髓瘤患者的常规治疗基础上进行后凸成形术和椎体成形术治疗可改善发病率和功能预后。

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