Effect of pedicle fixation combined with 125I seed implantation for metastatic thoracolumbar tumors

Abstract

PurposeThe aim of this study was to investigate the clinical efficacy of pedicle fixation combined with 125I brachytherapy in treating metastatic thoracolumbar tumors.Patients and methodsA retrospective analysis of the clinical data of seven metastatic thoracolumbar tumor patients who received pedicle fixation combined with radioactive 125I seed implantation brachytherapy in our department between January 2009 and December 2013 was performed. The visual analog scale (VAS) for pain and the Karnofsky performance status (KPS) score before the operation and 1, 6, and 12 months after the operation were observed and recorded. The changes in the scores at each time point were compared.ResultsAll the patients underwent a successful operation, without any complications during their hospitalization. All the patients received postoperative follow-up, and the duration of follow-up was 15–50 months, with an average of 32.2 months. One pancreatic cancer patient died of liver failure and hypoproteinemia 28 months post surgery. The VAS scores of patients before the operation and 1, 6, and 12 months after the operation were 7.43±0.98, 2.71±0.49, 3.00±0.82, and 4.29±0.98, respectively; the KPS scores were 52.9±9.5, 84.3±5.3, 75.7±5.3, and 72.9±4.9, respectively. These results suggest that the VAS score at each time point was significantly decreased compared with that before the operation, while the KPS score was significantly increased compared with that before the operation. Both differences had statistical significance (P<0.05).ConclusionAs a therapy for advanced malignant tumors with thoracolumbar metastasis, pedicle fixation combined with 125I brachytherapy can effectively relieve short-term pain and improve patient’s quality of life.

<p>A Comparative Study on the Effects of Postoperative ¹²⁵I Brachytherapy and Irradiation After Surgical Decompression and Stabilization for Metastatic Spinal Cancers</p>

“…Decompressive surgery combining with precise 125 I brachytherapy seed implantation facilitates rapid decompression, immediate metastatic radiation, and accurate tumor assessment, which has become a new modality for MESCC patients. 12 , 13 Rogers et al 13 reported that surgical resection and 125 I brachytherapy was well tolerated and resulted in durable local control and ambulatory function outcome in patients with MESCC. Thirty patients were included in the study.…”

“…The morbidity was restricted to 4 postoperative events. Qian et al 12 concluded that pedicle fixation combined with 125 I brachytherapy could effectively relieve short-term pain and improve patient’s quality of life after retrospectively analyzing seven metastatic thoracolumbar tumor patients. However, the available studies were subject to small retrospectively samples, simple observations, and indistinct endpoints.…”

“…10 , 11 Decompressive surgery combining with 125 I brachytherapy seed implantation facilitates rapid decompression, immediate metastatic radiation, and accurate tumor assessment, which has become a new modality for MESCC patients. 12 , 13 However, the available studies were subject to small and retrospective samples, simple observations, and indistinct endpoints. To our knowledge, there is no report comparing the efficacy and safety of surgical decompression and spine stabilization combined with 125 I brachytherapy and with postoperative radiotherapy in the treatment of MESCC patients.…”

Personalized Radiation Therapy in Cancer Pain Management

“…Recently, a systematic review was published, which summarized the role of the treatment modality in painful spinal metastases [82]. Seven studies (which analysed treatment efficacy on pain control) reported a decrease of pain intensity after brachytherapy [83,84,85,86,87,88,89] (Table 4).…”

Therapeutic value of 3-D printing template-assisted ¹²⁵I-seed&nbsp;implantation in the treatment of malignant liver tumors

“…In recent years, 125 I-seed implantation has been found to show very good therapeutic effects on malignant liver tumors 1. However, this treatment is always obscured by the costa and lung tissue, and displacement of the liver caused by breathing also makes treatment difficult.…”