title: Clinical efficacy of percutaneous vertebroplasty combined with intensity-modulated radiotherapy for spinal metastases in patients with NSCLC.
abstract: OBJECTIVE
  This study aimed to evaluate the safety and efficacy of percutaneous vertebroplasty (PVP) combined with intensity-modulated radiotherapy (IMRT) for metastatic lesions of patients with non-small-cell lung cancer (NSCLC) at centrum vertebrae.
  
  
  METHODS
  A total of 39 patients with spinal metastatic NSCLC (stage IV) were treated with PVP followed by IMRT (30 Gy/10F/2 W) for metastatic lesion at centrum vertebrae under local anesthesia. Retrospective analysis was done with medical records and radiological data. The change of visual analog scale (VAS), activities of daily living, and kyphotic angle was measured preoperatively. The presence of complications was assessed preoperatively (baseline) at 24 hours, 1 week, and 1, 3, 6, 12, and 24 months postoperatively, or until the patient died or was lost to follow-up. Survival was assessed in the group.
  
  
  RESULTS
  A total of 39 consecutive patients were successfully treated with PVP via a translateral approach and IMRT. Their mean VAS score decreased from 7.93±1.09 preoperatively to 4.14±1.15 by the 24-hour postoperative time point and was 3.92±1.23 at 1 week, 4.27±1.93 at 1 month, 3.24±1.35 at 3 months, 2.27±0.96 at 6 months, and 2.59±1.55 at 12 months after the procedure. The mean VAS score at all of the postoperative time points was decreased significantly from the preoperative baseline score (P<0.05). Activities of daily living evaluation showed that the patients had a significantly high life quality after the combined approach (50.9±11.7 vs 82.3±9.9, P<0.05). No severe complications were observed. Mild complications included two cases (5.13%) of asymptomatic cement leakage into the epidural space and one case (2.56%) of paravertebral leakage. Median survival time was extended to 13 months.
  
  
  CONCLUSIONS
  The safety and efficacy of PVP combined with IMRT in patients with NSCLC with metastatic lesions at centrum vertebrae and the ability to prevent the diseased vertebrae from further deformation and tumor infiltration into the vertebral body were demonstrated. PVP combined with IMRT should be the optimal technique for treatment of vertebral compression pain resulting from spinal metastatic NSCLC.
authors: Department of Cancer Center, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China ; Department of Oncology, Beibei Traditional Chinese Medical Hospital, Chongqing, People's Republic of China.
authors: Yi
authors: Y
authors: Li
authors: Department of Cancer Center, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China.
authors: Yi
authors: Y
authors: Qing
authors: Department of Oncology, Wuhan General Hospital of Guangzhou Command, People's Liberation Army, Wuhan, Hubei, People's Republic of China.
authors: Zhimin
authors: Z
authors: Zhang
authors: Department of Cancer Center, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China.
authors: Mengxia
authors: M
authors: Li
authors: Department of Cancer Center, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China.
authors: Jiaying
authors: J
authors: Xie
authors: Department of Cancer Center, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China.
authors: Ge
authors: G
authors: Wang
authors: Department of Cancer Center, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China.
authors: Dong
authors: D
authors: Wang
keywords: IMRT; NSCLC; percutaneous vertebroplasty; spinal metastases