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[目的]总结手术结合调强放疗综合治疗脊柱转移瘤的疗效。[方法]87例脊柱转移瘤患者,采用手术结合调强放疗的综合治疗,应用疼痛视觉模拟评分(visual analogue scale,VAS)于治疗前及治疗后3d、1个月、3个月进行评估、Frankel分级评估脊髓损害恢复情况。[结果]随访2年或者至患者死亡,所有患者近期疗效满意,局部疼痛及神经症状均有不同程度的缓解或改善。Frankel分级D、E级者由治疗前的48例(56.3%)提高到治疗后的67例(77.1%)。患者VAS评分治疗前为3~9分,平均7.1分,治疗后为0~6分,平均2.7分,差异有统计学意义。[结论]对于脊柱转移瘤患者进行手术联合调强放疗的综合治疗疗效好,手术能够减轻疼痛,改善神经功能,同时为椎体转移瘤的调强放疗提供了空间,手术后放疗能进一步控制肿瘤生长,提高患者生活质量,延长生存期。
[Objective] To summarize the curative effect of operation combined with intensity-modulated radiotherapy in the treatment of spinal metastases. [Methods] Eighty-seven patients with spinal metastases were treated with surgery combined with intensity-modulated radiotherapy. The visual analogue scale (VAS) was used to assess the symptoms before treatment, 3d, 1 month and 3 months after treatment. Frankel graded to assess spinal cord injury recovery. [Result] All patients were satisfied with the short-term curative effect, local pain and neurological symptoms were relieved or improved to some extent after 2 years of follow-up or until the patient died. Frankel grading D and E were improved from 48 cases (56.3%) before treatment to 67 cases (77.1%) after treatment. The VAS score of patients before treatment was 3 to 9 points, an average of 7.1 points after treatment was 0 to 6 points, an average of 2.7 points, the difference was statistically significant. [Conclusion] The comprehensive treatment of patients with spinal metastases combined with IMRT has good curative effect. The operation can relieve the pain and improve the nerve function. At the same time, it provides the space for IMRT of vertebral body metastases. The postoperative radiotherapy can further control the tumor Growth, improve patient quality of life and prolong survival.