The Clinical Efficacy Of Percutaneous Vertebroplasty Combined With ¹²⁵I Radioactive Seed Implantation For Spinal Metastasis

Objective To compare the clinical outcomes in local therapeutic efficacy,pain control,muscle strength grades of legs and performance status of percutaneous vertebroplasty（PVP）combined with¹²⁵I-seed implantation and percutaneous vertebroplasty for the treatment of metastatic vertebral carcinoma involving the spinal canal.It can provide more effective ways for clinical treatment.Methods Fifty-six patients with spinal metastatic tumor admitted to department of tumors intervention in Gansu the second provincial hospital in July 2015 to July 2016 was performed.The study group was with a matched control group by accumulative vertebral segment and age（±three years）.The study group was operated by percutaneous vertebroplasty combined with ¹²⁵I-seed implantation（n=28）.The control group was operated by percutaneous vertebroplasty（PVP）（n=28）.The local therapeutic efficacy were recoded 3 months after surgery.both before surgery and 2 days,1,3,6 months after surgery,the pain control,muscle strength grades of legs and performance status were recoded.Then it used ststistic methords to compare the statuses between two groups.Results1.There were no deference in age,levels of pain,muscle strength grades of legs,and physical condition between percutaneous vertebroplasty combined with ¹²⁵I-seed implantation and percutaneous vertebroplasty（P>0.05）.2.The ORR of percutaneous vertebroplasty combined with ¹²⁵I-seed implantation and percutaneous vertebroplasty were 53.57% and 25.00%.The DCR of two groups were 92.86% and60.71%.The ORR and DCR between two groups had significant difference（P<0.05）.3.After treatment 2 day,1 week,1month,3 months and 6 months,the efficiently of pain relief of percutaneous vertebroplasty combined with ¹²⁵I-seed implantation were 21.43%,100.00%,100.00%,96.15% and 100.00%.The efficiently of pain relief of percutaneous vertebroplasty were17.86%,53.57%,67.85%,62.96%和 62.50%.After treatment 1 week,1month,3 months and 6months,there were significant differences in efficiently of pain relief between two groups.4.After treatment 2day,1 week,1month,3 months and 6 months,The proportion of grade 4and 5 of muscle strength grades were 50.00%,92.86%,96.43%,96.15% and 100.00% in percutaneous vertebroplasty combined with ¹²⁵I-seed implantation.The proportion of grade 4 and5 of muscle strength grades were 28.57%,50.00%,53.57%,48.15% and 54.17% in percutaneous vertebroplasty.After treatment 1 week,1month,3 months and 6 months,The muscle strength grades between two groups had significant difference（P<0.05）.5.The score of KPS in percutaneous vertebroplasty combined with ¹²⁵I-seed implantation before operating was 46.79±12.49.After treatment 1 day,1 week,1month,3 months and 6 months,there were 56.43±11.93、65.36±9.22、78.57±12.08、76.15±9.41 and 71.25±9.92.There was significant difference in group（F=34.299,P=0.000<0.05）.The score of KPS in percutaneous vertebroplasty before operating was 46.43±11.93.After treatment 1 day,1 week,1month,3 months and 6 months,there were 57.50±12.06、63.93±11.33、64.29±11.68、61.48±10.99 and 57.91±11.79.There was significant difference in group（F=9.038,P=0.000<0.05）.Using t-test,After treatment1 month,3 months and 6 months,The score of KPS of two groups had significant difference（P<0.05）.6.The postoperative complication rate of percutaneous vertebroplasty combined with¹²⁵I-seed implantation and percutaneous vertebroplasty were 3.57% and 7.14%.There were non-significant difference between two groups（P>0.05）.Conclusions1.Percutaneous vertebroplasty combined with ¹²⁵I-seed implantation is also safe and effective treatment in improving the quality of life and pain relief.2.Percutaneous vertebroplasty combined with ¹²⁵I-seed implantation is greater efficacy than percutaneous vertebroplasty.