The Clinical Efficacy Of Percutaneous Vertebroplasty Compared With Radiotherapy For The Treatment Of Multiple Thoracolumbar Metastases

Objective To review and analyze the clinical efficacy of percutaneous vertebroplasty compared with radiotherapy for the treatment of multiple thoracolumbar metastases.Methods Follow-up 52 patients suffering from multiple thoracolumbar metastases that were treated with percutaneous vertebroplasty or radiotherapy in the Fourth Affiliated of Soochow University From Mar 2011 to Mar 2014. According to the treatment, all patients were divided into two groups, PVP group had 27 patients and radiotherapy group had 25 patient. Adopting questionnaire investigating way to collect the data of evaluating curative effect by telephone, letter and out-patient callback. All patients’ pain scale, quality of life, morphology change of vertebral, infiltration of tumor and complication were observed. Processed the gained data in a statistical way and analyzed the clinical efficacy of different groups.Results1. Compared with preoperative score, the scores of VAS and EORTC of PVP group were significantly decreased after operation 3 days(P<0.05), and was better than radiotherapy group(P<0.05). After treatment 1month,3 months and 6 months, the score of life quality and pain of two groups were significantly lower than those before treatment. And 6 months after the treatment, the efficacy between two groups had significant difference(P<0.05).2. At each time after treatment, the height of the vertebral body(anterior,median and posterior) in PVP group had no obvious change(P>0.05). However, after treatment 6 months, the height in radiotherapy had lost significantly compared with preoperative time and PVP group(P<0.05).3. In PVP group, there were 2 patients with 3 vertebras who was found pedicle tumor infiltration. 2 patients had new vertebral metastases. However, there were 4 patients had compression fracture. One of them appeared double lower limbs to be paralysed incompletely.4. The rate of cement leaking in PVP group is 39.7%(29/73). After operation, only 2 patients had lower limbs soreness and 1 patient had humeral fracture. In radiotherapy group, 11 patients occurred leucocyte reduction, constipation, bloating, nausea, vomiting and so on.Conclusion1. Percutaneous vertebroplasty and radiotherapy are also safe and effective treatment in improving the quality of life and pain relief.2. The efficacy of improving the quality of life and pain relief, PVP is faster and better than radiotherapy, and its ability of height maintain is better than radiotherapy.3. Radiotherapy is convenient and inexpensive;It can also kill tumor cells. But it has many side reactions. PVP’s wound is small. It recovers quickly and can enhance the stability of spine. However, it needs to prevent nerve damage which caused by puncture and bone cement leakage.