CT引导下经皮骨成形术治疗骨盆溶骨性转移肿瘤  

CT-guided percutaneous osteoplasty for the treatment of osteolytic metastases of the pelvis

作　　者：刘勇[1] 何仕诚[1] 朱海东[1] 方文[1] 杜瑞杰[1] 郭金和[1] 朱光宇[1] 陈荔[1] 滕皋军[1] LIU Yong;HE Shicheng;ZHU Haidong;FANG Wen;DU Ruijie;GUO Jinhe;ZHU Guangyu;CHEN Li;TENG Gaojun(Department of Interventional and Vascular Surgery,Affiliated Zhongda Hospital of Southeast University,Nanjing,Jiangsu Province 21009,China)

机构地区：[1]东南大学附属中大医院介入与血管外科,江苏南京210009

出　　处：《介入放射学杂志》2023年第12期1197-1201,共5页Journal of Interventional Radiology

摘　　要：目的评价CT导引下经皮骨成形术(percutaneous osteoplasty,POP)治疗骨盆转移性肿瘤的临床疗效及安全性。方法收集2011年10月至2021年12月东南大学附属中大医院应用CT引导下行POP治疗骨盆溶骨性转移瘤且随访资料完整的40例患者临床资料。采用视觉模拟量表(VAS)评价POP术后1周和1、3、6及12个月的临床疗效,并记录关节功能及止痛药物应用情况。比较术前和术后3、6、12个月骨盆肿瘤破坏范围的变化,评价肿瘤控制情况。根据随访12个月内局部病灶有无进展分为控制组与进展组,比较两组全身抗肿瘤治疗比例、病灶大小、骨水泥注入量以及骨水泥充填率。结果40例患者57处病灶POP操作均成功,骨水泥注入量为(4.56±2.25)mL/处。40例患者POP前、术后1周、术后1个月、术后3个月VAS评分分别为(8.00±0.85)、(2.05±0.96)、(2.08±0.94)、(2.18±0.84)分,术前与术后1周比较,差异有统计学意义(P<0.01);37例患者术后6个月VAS评分为(2.35±0.54)分,28例患者术后12个月VAS评分为(2.43±0.79)分,术后1周与术后1、3、6和12个月比较,差异无统计学意义(均P>0.05);术前与术后比较,差异有统计学意义(F=316.3,P<0.01)。术后3、6和12个月的局部控制率分别为96.49%、85.19%、78.12%,差异有统计学意义(P=0.026)。控制组与进展组全身抗肿瘤治疗比例、病灶大小及骨水泥注入量差异均无统计学意义(均P>0.05)。两组骨水泥充填率为(81.26±9.17)%比(68.40±12.98)%,差异有统计学意义(P<0.01)。结论CT引导下POP治疗骨盆转移瘤操作安全、疗效显著,骨水泥可较长时间控制局部病灶进展。Objective To evaluate the clinical efficacy and safety of CT-guided percutaneous osteoplasty(POP)in the treatment of osteolytic metastases of the pelvis.Methods The clinical data of a total of 40 patients with pelvic osteolytic metastases,who received CT-guided POP at the Affiliated Zhongda Hospital of Southeast University between October 2011 and December 2021,were collected.Visual analogue scale(VAS)score was used to evaluate the clinical pain relief degree at one week,one month,3 months,6 months and 12 months after POP,and the joint function and the used dose of analgesic drugs were recorded.The preoperative and the postoperative 3-month,6-month and 12-month extents of the pelvic tumor destruction were compared.Based on the progression of local lesions within 12 months of follow-up,the patients were divided into controlled group and progression group.The proportion of using systemic anti-tumor therapy,the size of lesion,the amount of bone cement injected,and the cement filling ratio were compared between the two groups.Results Successful surgical procedure was accomplished for 57 lesions in 40 patients.The mean amount of bone cement injected was(4.56±2.25)mL/point.In the 40 patients,the preoperative and the postoperative one-week,one-month and 3-month VAS score were(8.00±0.85)points,(2.05±0.96)points,(2.08±0.94)points and(2.18±0.84)points respectively,the difference in VAS score between preoperative value and postoperative one-week value was statistically significant(P<0.01).In 37 patients,the postoperative 6-month VAS score was(2.35±0.54)points;and in 28 patients,the postoperative 12-month VAS score was(2.43±0.79)points.The differences in VAS score between postoperative one-week value and postoperative one-month,3-month,6-month,and 12-month values were not statistically significant(all P>0.05),while the differences in VAS score between preoperative value and postoperative values were statistically significant(F=316.3,P<0.01).The postoperative 3-month,6-month,and 12-month local control rates were 96.49%

关 键 词：骨盆 转移瘤 溶骨性 经皮骨成形术 CT引导 

分 类 号：R738.1[医药卫生—肿瘤]