Effect of percutaneous vertebroplasty combined with 125Ⅰ radioactive seed implantation and traditional radiotherapy on local spinal metastatic tumor

Objective To study the effect of CT-guided percutaneous vertebroplasty (PVP) combined with 125Ⅰ seed implantation and traditional conventional radiotherapy on local spinal metastatic tumor. Methods Sixty-nine patients with spinal metastatic tumor admitted to our hospital from February 2011 to October 2012 were divided into group A (n=36) and group B (n=33). Patients in group A were treated with PVP combined with 125Ⅰ seed implantation and those in group B underwent conventional radiotherapy. The local reaction, pain relief and vertebral body collapse were compared between the two groups after treatment. Results All the patients completed the planned treatment. The CR, PR, SD, and PD were 0%, 88.9%, 11.1%, 0% respectively in group A and 0%, 60.6%, 21.2%, 18.2% respectively in group B 3 months after treatment. The clinical beneficial rate was 100% and 81.8% respectively in the two groups. The pain relief rate was 88.9%, 87.7%, 95.9% respectively in group A and 0%, 27.3%, 54.5% respectively in group B 1 day, 1 and 3 months after treatment. The incidence of aggravated vertebral body collapse and new compression fractures was significantly lower in group A than in group B (2.8% vs 30.3%, P ＜ 0.05). Bone cement leakage into the adjacent dural sac and the soft tissues along the needle path was found in 1 and 2 patients of group A respectively with no significant symptom during the follow-up. Gastrointestinal symptoms such as nausea and vomiting occurred in group B. Conclusion CT-guided PVP combined with 125Ⅰ seed implantation has a definite effect on spinal metastatic tumor and is more effective than conventional radiotherapy in relieving pain, preventing vertebral body collapse and compression fracture. It is thus a safe and reliabe minimally invasive treatment modality for local spinal metastatic tumor.