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Abstract 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 clin...
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Objectives: This study aims to assess the radiographic development of the acetabulum after closed reduction of developmental dysplasia of the hip in patients with different follow-up periods.
Methods: The authors undertook a retrospective review of clinical records and radiographs of children who were diagnosed with developmental dysplasia of the h...
Cartilage lesions are at a high prevalence in dysplastic hips and may relate to arthritic changes and hip joint dysfunction. To date, the effectiveness of repair of articular cartilage defects in the dysplastic hips has not yet been thoroughly evaluated. Here we retrospectively reviewed the effects of acetabuloplasty procedures with/without concomi...
Citations
... It is important to note that findings from these smaller studies are not always conclusive, as some show no difference in pain outcomes between brachytherapy with or without cement augmentation. 26,32,35,36 In a meta-analysis of all published 125 I brachytherapy data, monotherapy 125 I brachytherapy produced a mean pain reduction of ≥2 points, whereas brachytherapy with cement produced a greater mean pain reduction of ≥4 points. 2 Cardoso et al. 22 used the Eastern Cooperative Oncology Group (ECOG) Scale of Performance Status instead of KPS, but also found significant improvement and change from pretreatment to posttreatment. Another study by Wang et al. 26 also measured changes in daily living performance (eg, showering, eating, clothing, and bowel/bladder ...
Brachytherapy remains an underrecognized and underutilized radiation therapy modality for the treatment of spinal tumors. This article summarizes the existing body of medical literature on the usage, indications, techniques, and outcomes of brachytherapy for the treatment of spine tumors. The disease pathology most commonly treated with brachytherapy is metastatic spine cancer, rather than primary bone tumors of the spine. Brachytherapy can be used alone, as percutaneous needle injections; however, it is more often used in conjunction with open surgery or cement vertebral body augmentation. Although the data are still relatively sparse, studies show consistent benefit from brachytherapy in terms of improvements in pain, function, local recurrence rate, and overall survival. Brachytherapy is also associated with a favorable complication profile.
Aim
To evaluate the analgesic efficacy, safety, and local tumor control of iodine-125 (¹²⁵I) seed brachytherapy (BT) for the management of spine and bone metastases.
Methods
A systematic literature search was conducted using PubMed, the Cochrane Library, and Scopus databases. Data regarding patient demographics, tumor characteristics, procedural parameters, and clinical outcomes were extracted and analyzed.
Results
Fourteen studies (7 prospective, 7 retrospective) were included, accounting for 689 patients, in our review. Analgesic efficacy was assessed at baseline and various postoperative time points. Significant improvement in pain was noted at 4- and 24-week follow-ups (p < 0.01). Interestingly, all studies that combined ¹²⁵I seed BT with cement augmentation reported relatively higher levels of pain reduction (mean pain reduction ≥4 points) as compared to the studies which applied ¹²⁵I seed BT as a stand-alone therapy (mean pain reduction ≥2 points), at the last follow-up. Local tumor control rates ranged widely from 14% to 100% at varying follow-ups. Median overall survival ranged between 10 months and 25 months. The overall complication rate was 19% (130/689) and mainly included minor subcutaneous hemorrhage, fever, myelosuppression, and seed displacement. Metrics assessing performance and quality of life demonstrated significant improvements from baseline to posttreatment.
Conclusion
¹²⁵I seed BT, alone or in conjunction with cement augmentation, may be a viable salvage therapy in appropriately selected patients. However, further studies are needed to analyze the long-term efficacy of this intervention as a palliative and curative modality.
Background
Percutaneous vertebroplasty has been a good option to treat vertebral metastases. The pelvic bone is a common site of spread for many cancers. Using follow-up data for 126 patients, we evaluated the safety and efficacy of percutaneous osteoplasty (POP) to treat pelvic bone metastases.
Materials and Methods
In this retrospective study, 126 patients (mean age 57.45 ± 11.46 years old) with 178 lesions were treated using POP. The visual analog scale (VAS), Oswestry Disability Index (ODI), and the changes in the patient’s use of painkillers were used to evaluate pain and quality of life before the procedure, and at 3 days and 1, 3, 6, 9, and 12 months after the procedure.
Results
Technical success was achieved in all patients. The mean VAS scores decreased significantly from 6.87 ± 1.33 before the procedure to 3.33 ± 1.94 by day 3 after the procedure (P < 0.05), 2.26 ± 1.59 at 1 month (P < 0.05), 1.89 ± 1.53 at 3 months (P < 0.05), 1.87 ± 1.46 at 6 months (P < 0.05), 1.90 ± 1.47 at 9 months (P < 0.05), and 1.49 ± 1.17 at 12 months (P < 0.05). The ODI also changed after the procedure, with significant differences between baseline scores and at each follow-up examination (P < 0.05). Pain relief was achieved in 118 patients (93.65%); however, pain relief was not obvious in seven patients (5.56%), and pain was aggravated in one patient (0.79%). Extraosseous cement leakage occurred in 35 patients (27.78%) without causing any clinical complications.
Conclusion
Percutaneous osteoplasty is a safe and effective choice for patients with painful osteolytic pelvic bone metastases. It can relieve pain, reduce disability, and improve function.
Level of Evidence
Level 3b, retrospective study.
The treatment of the patient with bone metastases from prostate cancer is usually based on medical and radiation therapy [1–6]. Nevertheless, sometimes indication for surgery is present with:
