Comparison of external radiotherapy and percutaneous vertebroplasty for spinal metastasis

Aim To compare the efficacy of external radiotherapy ( ERT ) and percutaneous vertebroplasty ( PVP ) for spinal metastasis. Methods A total of 137 patients with 174 spinal metastases between J une 2006 and A pril 2009 in our hospital were reviewed. For their spinal metastasis, 52 patients received ERT ; 46 patients received PVP ; and 39 patients received both ERT and PVP . Pain and neurological deficit response, overall survival, and side effects were evaluated. Results ERT combined with PVP achieved pain remission in 84.8% of the patients, which was higher than ERT (72.5%) or PVP (76.3%) alone. It also showed a higher remission rate of neurological deficits (50%) than ERT (18.2%) or PVP (11.1%) alone. Toxicities from the employed treatments were mild. The K arnofsky Performance Score and visceral or brain metastases were the significant influencing factors for overall survival. Patients with spinal metastases derived from breast cancer had a significantly better overall survival than those whose spinal metastases were derived from lung cancer. Conclusion ERT combined with PVP can be a more effective treatment for spinal metastases; however, prospective randomized trials are needed to draw any definitive conclusion.