title: Percutaneous vertebroplasty combined with zoledronic acid for the treatment of painful osteolytic spinal metastases in patients with breast cancer.
abstract: OBJECTIVE
  To assess retrospectively the efficacy and safety of percutaneous vertebroplasty (PVP) combined with zoledronic acid (ZA) for the treatment of painful osteolytic spinal metastases from breast cancer.
  
  
  METHODS
  PVP was performed in 43 patients with breast cancer and painful osteolytic spinal metastases; 126 vertebrae were treated. The patients subsequently received 4 mg ZA via a 15-minute intravenous infusion every 4 weeks for 12 months. Pain and quality of life (QoL) were assessed using a visual analog scale (VAS) and Karnofsky performance scale (KPS), respectively, 24 hours before PVP and 24 hours, 1 month, 3 months, 6 months, and 12 months after PVP. Skeletal-related events (SREs) were assessed for 12 months following the intervention.
  
  
  RESULTS
  The mean VAS scores decreased significantly from 7.6 ± 1.9 at 24 hours before PVP to 3.6 ± 1.4 at 24 hours, 2.0 ± 1.5 at 1 month, 2.8 ± 1.6 at 3 months, 3.1 ± 0.8 at 6 months, and 2.5 ± 0.9 at 12 months after the intervention (P < .05). KPS scores increased significantly after the combination treatment (P < .05). Compared with previous studies without PVP or ZA treatment, this patient group had a lower incidence of SREs. No major complications were observed.
  
  
  CONCLUSIONS
  PVP combined with ZA was shown to be a highly effective and safe combination therapy to relieve pain and improve QoL in patients with osteolytic spinal metastases from breast cancer. The combination therapy also prevented the occurrence of SREs.
authors.affiliation: Department of Internal Oncology, Sixth People's Hospital, Shanghai JiaoTong University, 600 Yishan Road, Shanghai 200233, China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Zhang
authors.forename: Yonggang
authors.initials: Y
authors.lastname: Wang
authors.forename: Kun
authors.initials: K
authors.lastname: Han
authors.forename: Lina
authors.initials: L
authors.lastname: Tang
authors.forename: Haiyan
authors.initials: H
authors.lastname: Hu
authors.forename: Chungen
authors.initials: C
authors.lastname: Wu
authors.forename: Zan
authors.initials: Z
authors.lastname: Shen
authors.forename: Yuanjue
authors.initials: Y
authors.lastname: Sun
authors.forename: Yang
authors.initials: Y
authors.lastname: Yao
mesh_terms: D000328:Adult; D000368:Aged; D001416:Back Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000473:pathology*; D003131:Combined Modality Therapy; D004164:Diphosphonates / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D017567:Karnofsky Performance Status; D008875:Middle Aged; D010014:Osteolysis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D010147:Pain Measurement; D011788:Quality of Life; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid
keywords: KPS; Karnofsky performance scale; PVP; QoL; SMR; SREs; VAS; ZA; percutaneous vertebroplasty; quality of life; skeletal morbidity rate; skeletal-related events; visual analog scale; zoledronic acid