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Clinical efficacy of percutaneous vertebroplasty combined with intensity-modulated radiotherapy for spinal metastases in patients with NSCLC.

Li Y, Qing Y, Zhang Z, Li M, Xie J, Wang G, Wang D - Onco Targets Ther (2015)

Bottom Line: 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).

View Article: PubMed Central - PubMed

Affiliation: 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.

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.

Conclusion: 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.

No MeSH data available.


Related in: MedlinePlus

Visual analog scale (VAS) change of patients of at each pre- and postoperative follow-up time.Notes: Data are expressed as mean ± standard deviation. The differences between the VAS scores prior to VP and at 1 day, 1 week, and 1, 3, 6, and 12 months, respectively, are statistically significant (P<0.05). *P<0.05 in comparison to preoperative.Abbreviations: Preop, preoperative; VP, vertebroplasty; N, number of follow-up patients.
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f3-ott-8-2139: Visual analog scale (VAS) change of patients of at each pre- and postoperative follow-up time.Notes: Data are expressed as mean ± standard deviation. The differences between the VAS scores prior to VP and at 1 day, 1 week, and 1, 3, 6, and 12 months, respectively, are statistically significant (P<0.05). *P<0.05 in comparison to preoperative.Abbreviations: Preop, preoperative; VP, vertebroplasty; N, number of follow-up patients.

Mentions: Thirty-nine consecutive patients were successfully treated with PVP via a translateral approach combined with IMRT. All the PVP procedures were completed within 40 minutes to 1 hour. The numbers of patients available for VAS evaluation at each follow-up interval were 39 (100%) at 24 hours and 1 week, 38 (97.44%) at 1 month, 27 (68.23%) at 3 months, 17 (43.59%) at 6 months, and 6 (15.38%) at 1 year. 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 differed significantly from the preoperative baseline score (P<0.05; Figure 3). ADL evaluation showed that the patients had a significantly high life quality after the operation for 6 months (50.9±11.7 vs 82.3±9.9, P<0.05; Table 2). No other severe complications were observed. Mild complications included two cases (4.86%) of asymptomatic cement leakage into the epidural space and one case (2.43%) of paravertebral leakage.


Clinical efficacy of percutaneous vertebroplasty combined with intensity-modulated radiotherapy for spinal metastases in patients with NSCLC.

Li Y, Qing Y, Zhang Z, Li M, Xie J, Wang G, Wang D - Onco Targets Ther (2015)

Visual analog scale (VAS) change of patients of at each pre- and postoperative follow-up time.Notes: Data are expressed as mean ± standard deviation. The differences between the VAS scores prior to VP and at 1 day, 1 week, and 1, 3, 6, and 12 months, respectively, are statistically significant (P<0.05). *P<0.05 in comparison to preoperative.Abbreviations: Preop, preoperative; VP, vertebroplasty; N, number of follow-up patients.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4548765&req=5

f3-ott-8-2139: Visual analog scale (VAS) change of patients of at each pre- and postoperative follow-up time.Notes: Data are expressed as mean ± standard deviation. The differences between the VAS scores prior to VP and at 1 day, 1 week, and 1, 3, 6, and 12 months, respectively, are statistically significant (P<0.05). *P<0.05 in comparison to preoperative.Abbreviations: Preop, preoperative; VP, vertebroplasty; N, number of follow-up patients.
Mentions: Thirty-nine consecutive patients were successfully treated with PVP via a translateral approach combined with IMRT. All the PVP procedures were completed within 40 minutes to 1 hour. The numbers of patients available for VAS evaluation at each follow-up interval were 39 (100%) at 24 hours and 1 week, 38 (97.44%) at 1 month, 27 (68.23%) at 3 months, 17 (43.59%) at 6 months, and 6 (15.38%) at 1 year. 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 differed significantly from the preoperative baseline score (P<0.05; Figure 3). ADL evaluation showed that the patients had a significantly high life quality after the operation for 6 months (50.9±11.7 vs 82.3±9.9, P<0.05; Table 2). No other severe complications were observed. Mild complications included two cases (4.86%) of asymptomatic cement leakage into the epidural space and one case (2.43%) of paravertebral leakage.

Bottom Line: 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).

View Article: PubMed Central - PubMed

Affiliation: 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.

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.

Conclusion: 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.

No MeSH data available.


Related in: MedlinePlus