Objective: To evaluate the effectiveness of cement augmentation on the osteolytic lesion in patients with vertebral metastasis. Methods: A total of consecutive 132 patients with 268 vertebral metastatic lesions treated with PVP from January 2008 to December 2016 in Zhongda Hospital were enrolled in this study. Retrospective analysis of preoperative, postoperative 3 days, 3 months, 6 months, 12 months and ≥ 18 months imaging data on CT, the local control and progression of the tumor were evaluated by MDA response criteria. The local control rates were compared between the groups with the different rate of cement filling by Chi2-test. Results: Vertebroplasty procedures were performed successfully in all 268 vertebrae under DSA guidance, and the mean volume of PMMA injected in each vertebra was 0.7-8.5(3.9±1.5)ml.The rate of local control at 3 months, 6 months, 12 months and ≥18 months after PVP was respectively 98.9%, 95.1%, 91.8%, and 85.2%, the difference was statistically significant(all P<0.05). The local control rate showed a statistically significant relationship to the groups with the rate of cement filling at 6 months, 12 months and ≥18 months after PVP, but there was no statistical difference at postoperative 3 months. The rate of local control was higher in 68 patients with lung or gastrointestinal cancer than in 17 patients with liver or kidney cancer at 3 months, 6 months and 12 months, the difference was statistically significant (P<0.05). Conclusion: Cement augmentation has a local anti-tumor effect on vertebral osteolytic metastatic lesion, and the anti-tumor effect will decrease as the follow-up time extended.
目的： 评估骨水泥充填对椎体溶骨型转移肿瘤的局部控制作用。 方法： 收集2008年1月至2016年12月东南大学附属中大医院应用经皮椎体成形术(PVP)治疗椎体溶骨型转移患者且CT随访资料完整的132例268节椎体，回顾性分析术前，术后3 d，3、6、12及≥18个月椎体内肿瘤破坏范围的变化，参照美国MD Anderson(MDA)癌症中心骨转移瘤评估标准评价肿瘤控制情况，并比较不同骨水泥充填组间肿瘤控制率的差异。根据CT图像评价将靶椎破坏区骨水泥充填程度分为两组：完全充填组和骨水泥周围有残余破坏组。 结果： 268节椎体成形均获成功，平均注入骨水泥0.7～8.5(3.9±1.5)ml/节。术后3、6、12及≥18个月靶椎体控制率分别为98.9%、95.1%、91.8%、85.2%，各时间点靶椎体控制率差异均有统计学意义(均P<0.05)。术后3个月两组靶椎体局部控制率差异无统计学意义(P＝0.103)，6、12及≥18个月各时间点完全充填组靶椎控制率高于残余破坏组，差异均有统计学意义(均P<0.05)。肺癌＋胃肠癌等患者68例135节术后3、6及12个月靶椎体控制率高于肝癌＋肾癌17例36节，差异有统计学意义(P<0.05)。 结论： 骨水泥充填对椎体溶骨型转移肿瘤具有控制作用，随着时间延长呈下降趋势。.
Keywords: Methylmethacrylates; Neoplasm metastasis; Osteolytic; Vertebroplasty.