摘要
目的探讨放射性碘125粒子植入联合射频消融(radio frequency ablation,RFA)治疗脊柱转移瘤患者的效果。方法选取2017年1月—2019年12月收治的294例脊柱转移瘤患者,根据治疗方法分为观察组(n=196)和对照组(n=98)。2组均应用经皮椎体后凸成形术联合RFA治疗,观察组在此基础上增加放射性碘125粒子植入治疗。比较2组疗效及并发症;治疗前及治疗后6、12个月时,评估2组疼痛程度[视觉模拟评分法(visual analogne scale,VAS)]、椎体功能改善情况[日本骨科学会评分(Japanese orthopaedic association,JOA)]、生活质量[Oswestry功能障碍指数(oswestry disability index,ODI)]。结果2组治疗后6个月复发转移、骨水泥泄漏、并发症发生率比较差异均无统计学意义(P>0.05),观察组治疗后12个月复发转移率低于对照组(P<0.05)。治疗后6、12个月,2组VAS、ODI评分较治疗前均呈持续下降趋势,JOA评分较治疗前均呈持续上升趋势,差异有统计学意义(P<0.01)。2组治疗前后各时间点VAS评分和JOA评分比较差异无统计学意义(P>0.05),观察组治疗后12个月ODI评分显著低于对照组(P<0.01),不同治疗方案VAS评分和JOA评分与时间不存在交互效应(P>0.05),不同治疗方案ODI评分与时间存在交互效应(P<0.01)。结论放射性碘125粒子植入联合RFA治疗脊柱转移瘤效果优于RFA单方案治疗,能降低患者治疗后近期复发率。
Objective To investigate the effect of radioactive iodine 125 particle implantation combined with radiofrequency ablation(RFA)in the treatment of patients with metastatic spinal tumor(MST).Methods A total of 294 patients with MST admitted from January 2017 to December 2019 were enrolled in this study,and the patients were divided into observation group(n=196)and control group(n=98)according to the treatment methods.Both groups were treated with percutaneous kyphoplasty(PKP)combined with RFA,and the observation group was additionally given radioactive iodine 125 particle implantation on this basis.The efficacy and complications of the two groups were compared.The severity of pain[visual analogue score(VAS)],improvement of vertebral body function[Japan Orthopaedic Association Score(JOA)]and quality of life[Oswestry Dysfunction Index(ODI)]of both groups were evaluated before treatment and at 6 months and 12 months after treatment.Results There were no statistically significant differences in the incidence rates of recurrence and metastasis,bone cement leakage,and complications at 6 months after treatment between the two groups(P>0.05).The recurrence and metastasis rate of observation group at 12 months after treatment was lower than that of control group(P<0.05).At 6 and 12 months after treatment,the scores of VAS and ODI in the two groups showed a continuous downward trend compared with those before treatment,and the JOA scores of the two groups showed a continuous upward trend compared with those before treatment(P<0.01).There were no statistically significant differences in the VAS and JOA score at each time point before and after treatment between the two groups(P>0.05),and the ODI score at 12 months after treatment in the observation group was significantly lower than that in the control group(P<0.01).There were no interaction effects between the VAS score,JOA score and time point of different treatment options(P>0.05).There was an interaction effect between ODI score and time point for different treatment options(P<0.01).Conclusion Radioactive iodine 125 particle implantation combined with RFA is more effective than RFA alone in the treatment of MST,and can reduce the recent recurrence rate after treatment.
作者
陆丹
杜振广
黄聪
李福生
LU Dan;DU Zhen-guang;HUANG Cong;LI Fu-sheng(the Third Department of Oncology,People's Hospital of Liaoning Province,Shenyang,Liaoning 121004,China)
出处
《解放军医药杂志》
CAS
2021年第3期37-40,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
辽宁省自然科学基金项目(20190550210)。
