title: [Comparison of curative effect and prognosis analysis of patients with spinal metastases treated by percutaneous vertebroplasty combined with postoperative radiotherapy and radiotherapy alone].
abstract: Objective:To evaluate the efficacy of percutaneous vertebroplasty(PVP) combined with postoperative radiotherapy and radiotherapy alone in the treatment of spinal metastatic tumors and to evaluate the prognostic factors for survival.Methods:From December 2011 to December 2015, according to the choice of treatment, patients in group A(60 cases) were treated with PVP combined with postoperative radiotherapy and those in group B(50 cases) underwent radiotherapy alone, age, sex, primary tumor type , and other basic characteristics were analyzed in both groups in department of orthopedics and radiotherapy department, 307 Hospital of the People's Liberation Army. The pain visual analogue scale(visual analogue scale, VAS), tumors of the spine instability score(the spinal instability neoplastic score and sins), physical status score(Karnofsky performance score and KPS) were used to evaluate pain, spinal stability improvement and physical condition. Kaplan-Meier was used to analyze the survival rates of two groups of patients and the influence of primary tumor types on the survival of patients; Cox proportional hazard model was used to calculate the correlations between survival and visceral metastases, system medical treatment, vertebral number before treatment and physical condition.Results:There was no significant difference in baseline data between the two groups(P>0.05). The VAS in the group A was significantly lower than the scores in the group B at 1 month, 3 months, 6 months, and 12 months after surgery. The SINS score dropped from(7.8±1.2) to(6.3±0.9)(1 month), (6.1±0.8)(3 months) in patients with PVP combined with postoperative radiotherapy(P<0.05), the SINS score of radiotherapy patients simply dropped from(7.6±0.9) to(7.4±0.7)(1 month), (7.3±0.6)(3 months), and there was no statistically significant difference(P=0.12). The survival rates of 6 months, 1 years, and 3 years were similar between two groups(P>0.05). The influence of different types of primary tumors on the survival time of the patients was statistically significant(P<0.05). Multiple analysis showed that the internal organs metastasis, systemic medical treatment, the number of vertebral bodies and the physical condition were the important prognostic factors of the survival in patients with spinal metastases.Conclusion:PVP combined with postoperative radiotherapy for spinal metastases is better than radiotherapy alone in the treatment of relieving pain, maintaining the stability of vertebral body and improving the quality of life of patients. Survival prognosis was similar in two groups. The types of primary tumors, visceral metastasis, systemic medical treatment, the number of vertebral bodies and the physical condition are important prognostic factors in the survival of patients with spinal metastases.
authors.affiliation: Departemt of Orthopedic Surgery, the People's Liberation Army 307 Hospital, Anhui Medical University, Beijing 100071, China.
authors.forename: X Y
authors.initials: XY
authors.lastname: Cao
authors.forename: Y S
authors.initials: YS
authors.lastname: Liu
authors.forename: M X
authors.initials: MX
authors.lastname: Lei
authors.forename: S B
authors.initials: SB
authors.lastname: Liu
authors.forename: S G
authors.initials: SG
authors.lastname: Zhou
authors.forename: Y C
authors.initials: YC
authors.lastname: Cao
authors.forename: W G
authors.initials: WG
authors.lastname: Jiang
mesh_terms: D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain; D059408:Pain Management; D010147:Pain Measurement; D011379:Prognosis; D016016:Proportional Hazards Models; D011788:Quality of Life; D013125:Spinal Neoplasms / Q000532:radiotherapy / Q000556:secondary; D013131:Spine; D015996:Survival Rate; D054854:Vertebroplasty