World Journal of Surgical Oncology | |
Study of treatment using percutaneous acetabuloplasty and interstitial implantation of 125I seeds for patients with metastatic periacetabular tumors | |
Yunshan Yang2  Kun Li1  Hongpu Sun5  Pengjie Liu3  Jinde Wang4  Jiaping Wang6  Zuozhang Yang5  Jinlei Zhang5  | |
[1] Department of Radiology, The Third Affiliated Hospital of Kunming Medical University, Tumor Hospital of Yunnan Province, Kunming, 650118, P.R. China;Department of intervention therapy, The Third Affiliated Hospital of Kunming Medical University, Tumor Hospital of Yunnan Province, Kunming, 650118, P.R. China;Department of Nuclear Medicine, The Third Affiliated Hospital of Kunming Medical University, Tumor Hospital of Yunnan Province, Kunming, 650118, P.R. China;Kunming Medical University, Kunming, Yunnan, 650118, P.R. China;Department of Orthopedics, The Third Affiliated Hospital of Kunming Medical University, Tumor Hospital of Yunnan Province, Kunming, 650118, P.R. China;Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650118, P.R. China | |
关键词: Bone cement; Percutaneous acetabuloplasty; 125I seed implantation; Metastatic tumor; Periacetabular; | |
Others : 826873 DOI : 10.1186/1477-7819-10-250 |
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received in 2012-06-09, accepted in 2012-10-31, 发布年份 2012 | |
【 摘 要 】
Background
The periacetabular area is one of the primary sites of metastatic tumors, which often present as osteolytic bone destruction. Bone destruction in the acetabulum caused by metastatic tumors will cause hip pain and joint dysfunction. It results in decreased quality of life for patients. The aim of our study was to explore the clinical effect of metastatic periacetabular tumors treated with percutaneous cementoplasty and interstitial implantation of 125I seeds.
Methods
A retrospective analysis was performed on 24 patients with metastatic periacetabular tumors who underwent combined therapy of percutaneous acetabuloplasty and interstitial implantation of 125I seeds between February 2003 and June 2011. There were 13 males and 11 females aged 19–80 years with a mean age of 57.3. The primary tumor site was the lung in eight cases, the breast in six, the prostate cancer in eight, and the liver in two. The amount of implanted 125I seeds was 12–20 seeds/person, with a mean of 16.5 seeds/person, and the matching peripheral dosage (MPD) was 80~100Gy. Routine postoperative chemotherapy and other combined treatments were applied to patients after the surgical operation. Changes in the Karnofsky Score(KPS), Harris Hip Score(Harris), and Visual Analog Scale(VAS) were observed during the follow-up period.
Results
The 24 patients’ operations were all successful. No major complications occurred. Complete pain relief was achieved in 58% (14 of 24) of patients, and pain reduction was achieved in the 42% remaining (10) patients. The mean duration of pain relief was 8.3 months. Pain recurred in one patient 3 months after surgery. Six patients had died and 18 patients were alive at the time of the 1-year follow-up. Comparing the KPS, Harris and VAS scores pre- and postoperativelyat 1, 6, and 12 months, the combined therapy method was significantly effective in metastatic periacetabular tumor patients (P<0.05).
Conclusions
Percutaneous cementoplasty with interstitial implantation of 125I seeds is an effective treatment method for metastatic periacetabular tumor patients, providing tumor resistance, pain relief, increased bone stability, and improved quality of life for patients.
【 授权许可】
2012 Zhang et al.; licensee BioMed Central Ltd.
【 预 览 】
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【 参考文献 】
- [1]Khan FA, Rose PS, Yanagisawa M, Lewallen DG, Sim FH: Surgical technique: porous tantalum reconstruction for destructive nonprimary periacetabular tumors. Clin Orthop Relat Res 2012, 470:594-601.
- [2]Gilbert H, Kagan A, Nussbaum H, Rao A, Satzman J, Chan P, Allen B, Forsythe A: Evaluation of radiation therapy for bone metastases: pain relief and quality of life. Am J Roentgenol 1977, 129:1095-1096.
- [3]Shepherd S: Radiotherapy and the management of metastatic bone pain. Clin Radiol 1988, 39:547-550.
- [4]Harrington KD: The management of acetabular insufficiency secondary to metastatic malignant disease. J Bone Joint Surg Am 1981, 63:653-664.
- [5]Ho L, Ahlmann ER, Menendez LR: Modified Harrington reconstruction for advanced periacetabular metastatic disease. J Surg Oncol 2010, 101:170-174.
- [6]Cottias P, Jeanrot C, Vinh TS, Tomeno B, Anract P: Complications and functional evaluation of 17 saddle prostheses for resection of periacetabular tumors*. J Surg Oncol 2001, 78:90-100.
- [7]Uchida A, Myoui A, Araki N, Yoshikawa H, Ueda T, Aoki Y: Prosthetic reconstruction for periacetabular malignant tumors. Clin Orthop Relat Res 1996, 326:238.
- [8]Satcher RL Jr, O'Donnell RJ, Johnston JO: Reconstruction of the pelvis after resection of tumors about the acetabulum. Clin Orthop Relat Res 2003, 409:209.
- [9]Baliski CR, Schachar NS, McKinnon JG, Stuart GC, Temple WJ: Hemipelvectomy: a changing perspective for a rare procedure. Can J Surg 2004, 47:99.
- [10]Langlais F, Lambotte J, Thomazeau H: Long-term results of hemipelvis reconstruction with allografts. Clin Orthop Relat Res 2001, 388:178.
- [11]Delloye C, Banse X, Brichard B, Docquier PL, Cornu O: Pelvic reconstruction with a structural pelvic allograft after resection of a malignant bone tumor. J Bone and Joint Surg (Am) 2007, 89:579-587.
- [12]Mankin HJ, Hornicek FJ, Temple HT, Gebhardt MC: Malignant tumors of the pelvis: an outcome study. Clin Orthop Relat Res 2004, 425:212.
- [13]Marcy PY, Palussière J, Magné N, Bondiau PY, Ciais C, Bruneton JN: Percutaneous cementoplasty for pelvic bone metastasis. Support Care Cancer 2000, 8:500-503.
- [14]Harty J, Brennan D, Eustace S, O'Byrne J: Percutaneous cementoplasty of acetabular bony metastasis. Surgeon 2003, 1:48-50.
- [15]Scaramuzzo L, Maccauro G, Rossi B, Messuti L, Maffulli N, Logroscino CA: Quality of life in patients following percutaneous PMMA acetabuloplastyforacetabular metastasis due to carcinoma. Acta OrthopædicaBelgica 2009, 75:484.
- [16]Dobelbower R, Borgelt B, Strubler K, Kutcher G, Suntharalingam N: Precision radiotherapy for cancer of the pancreas: technique and results. Int J Radiat Oncol Biol Phys 1980, 6:1127-1133.
- [17]Minsky BD, Hilaris B, Fuks Z: The role of radiation therapy in the control of pain from pancreatic carcinoma. J Pain Symptom Manage 1988, 3:199.
- [18]Montemaggi P, Dobelbower R, Crucitti F, Caracciolo F, Morganti AG, Smaniotto D, Luzi S, Cellini N: Interstitial brachytherapy for pancreatic cancer: Report of seven cases treated with 125I and a review of the literature. Int J Radiat Oncol Biol Phys 1991, 21:451-457.
- [19]Maccauro G, Liuzza F, Scaramuzzo L, Milani A, Muratori F, Rossi B, Waide V, Logroscino G, Logroscino C, Maffulli N: Percutaneous acetabuloplasty for metastatic acetabular lesions. BMC Musculoskelet Disord 2008, 9:66. BioMed Central Full Text
- [20]Ji T, Guo W, Yang RL, Tang S, Sun X: Clinical outcome and quality of life after surgery for peri-acetabular metastases. J Bone Joint Surg Br 2011, 93:1104-1110.
- [21]Enneking WF, Dunham W: Resection and reconstruction for primary neoplasms involving the innominate bone. J Bone Joint Surg Am 1978, 60:731.
- [22]Marco RAW, Sheth DS, Boland PJ, Wunder JS, Siegel JA, Healey JH: Functional and oncological outcome of acetabular reconstruction for the treatment of metastatic disease*. J Bone and Joint Surg (Am) 2000, 82:642-651.
- [23]Cotten A, Deprez X, Migaud H, Chabanne B, Duquesnoy B, Chastanet P: Malignant acetabularosteolyses: percutaneous injection of acrylic bone cement. Radiology 1995, 197:307-310.
- [24]Kelekis A, Lovblad KO, Mehdizade A, Somon T, Yilmaz H, Wetzel SG, Seium Y, Dietrich PY, Rufenacht DA, Martin JB: Pelvic osteoplasty in osteolytic metastases: technical approach under fluoroscopic guidance and early clinical results. J Vasc Interv Radiol 2005, 16:81-88.
- [25]Sapkota BH, Hirsch AE, Yoo AJ, Hornicek FJ, Raskin KA, Rosenthal DI, Growney ML, Hirsch JA: Treatment of metastatic carcinoma to the hip with CT-guided percutaneous acetabuloplasty: report of four cases. J Vasc Interv Radiol 2009, 20:548-552.
- [26]Wang J, Jiang Y, Li J, Tian S, Ran W, Xiu D: Intraoperative ultrasound-guided iodine-125 seed implantation for unresectable pancreatic carcinoma. J ExpClin Cancer Res 2009, 28:88.
- [27]Zhongmin W, Yu L, Fenju L, Kemin C, Gang H: Clinical efficacy of CT-guided iodine-I seed implantation therapy in patients with advanced pancreatic cancer. Eur Radiol 2010, 20:1786-1791.
- [28]Munk PL, Rashid F, Heran MK, et al.: Combined cementoplasty and radiofrequency ablation in the treatment of painful neoplastic lesions of bone. J Vasc Interv Radiol 2009, 20(7):903-911.
- [29]Lane MD, Le HB, Lee S, et al.: Combination radiofrequency ablation and cementoplasty for palliative treatment of painful neoplastic bone metastasis: experience with 53 treated lesions in 36 patients. Skeletal Radiol 2011, 40(1):25-32.
- [30]Yang Z, Yang D, Xie L, Sun Y, Huang Y, Sun H, Liu P, Wu Z: Treatment of metastatic spinal tumors by percutaneous vertebroplasty versus percutaneous vertebroplasty combined with interstitial implantation of 125I seeds. Acta Radiol 2009, 50:1142-1148.