Clinical Observation Of Radiofrequency Ablation Combined With Percutaneous Vertebroplasty,Radiotherapy And Analgesics In The Treatment Of Pain Patients With Tumor Vertebral Metastasis

Objective: To observe the pain relief,functional recovery,dosage of analgesic drugs,satisfaction,adverse effects after treatment,and tumor progression of patients with pain caused by tumor vertebral metastasis treated with radiofrequency ablation combined with percutaneous vertebroplasty,radiotherapy,and analgesic drugs.Methods: The patients with pain of tumor vertebral metastasis admitted to our hospital from September 2018 to September 2022 were divided into three groups:Group A was radiofrequency ablation combined with percutaneous vertebroplasty,Group B was radiotherapy,and Group C was analgesic drug group.After follow-up treatment,1 day,3 days,7 days,1 month,3 months,6 months VAS(Visual analogue scale,VAS)score,KPS(Karnofsky performance score,KPS)score,analgesic drug dose change,patient satisfaction,adverse effects before treatment,tumor progression.Results: The VAS score of Group A at any time after treatment was significantly lower than that of Group B and Group C(P<0.05).The KPS score was significantly higher than those in Group B and Group C(P<0.05).The dose of analgesic drugs was significantly lower than that of Group B and Group C(P<0.05).The satisfaction rate was significantly higher than that in Group B and Group C(P<0.05).Adverse effects occurred in 4 patients.1 patient developed new tumor lesion.There was no difference between the VAS score in Group B and Group C at 1day,3 days,7 days,and 1 month after treatment(P>0.05),and the rest of the time was lower than that in Group C(P<0.05).The KPS score was higher than that of Group C at 7 days,1 month,3 months,and 6 months after treatment(P<0.05).The dose of analgesic drugs was lower than that of Group C(P<0.05)3 days,7 days,1month,3 months,and 6 months after treatment;Satisfaction was higher than that of Group C(P<0.05)at 1,3 and 6 months after treatment,and adverse effects occurred in 9 patients.3 patients developed new tumor lesions.In Group C,14 patients experienced adverse effects,and 4 patients deve loped new lesions of vertebral metastasis.VAS score decreased at any time after treatment compared with before treatment(P<0.05).Group A had an increase in KPS score(P<0.05)at any time after treatment compared with before treatment,Group B increased its KPS score at 7days,1 month,3 months,and 6 months after treatment(P<0.05),Group C had a decrease in KPS score at 3 months and 6 months compared with before treatment(P<0.05),and there was no difference between the rest of the time and before treatment(P>0.05),Group A decreased the dose of analgesic drugs at any time after treatment compared with before treatment(P<0.05),and Group B decreased the dose of analgesic drugs at 3 days,7 days and 1 month after treatment compared with before treatment(P<0.05).Group C had an increase in analgesic drugs doses at 7days,1 month,3 months,and 6 months after treatment compared with before treatment(P<0.05)Conclusion:Radiofrequency ablation combined with percutaneous vertebroplasty is superior to radiotherapy and analgesic drug therapy in terms of analgesic effect,functional recovery,analgesic drug dosage,satisfaction,adverse effects and tumor development compared to radiotherapy and analgesic drug therapy.The treatment effect is the best for patients with tumor vertebral metastasis.Radiotherapy is superior to analgesic drug therapy in terms of analgesic effect,functional state recovery,analgesic drug dosage,satisfaction,adverse effects,and tumor development.Therefore,radiofrequency ablation combined with percutaneous vertebroplasty is the first choice for the treatment of pain caused by bone metastases from tumors,and is recommended for clinical use.Analgesic drugs do not change the patient’s functional recovery,the dose of analgesic drugs is gradually increased,and there are many adverse effects.