Shanghai Jiao Tong University
Jianjun Zhang has completed his MD from Fudan University School of Medicine. He is an attending physician in Department of Internal Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital. He has published more than 10 papers in reputed journals. His main research interests are interventional treatment of tumor, such as percutaneous vertebroplasty and so on. His research was funded by Shanghai municipal bureau of health.
Purpose: To retrospectively assess the efficacy and safety of percutaneous vertebroplasty (PVP) combined with zoledronic acid (ZA) for the treatment of painful osteolytic spinal metastases from breast cancer, focusing on pain relief, improvement in quality of life (QoL) and occurrence of skeletal-related events (SREs). Materials and Methods: 43 patients with breast cancer and painful osteolytic spinal metastases underwent PVP, with a total of 126 vertebrae treated. Subsequently they received 4 mg ZA every 4 weeks for 12 months. Clinical outcomes were assessed, pain and QoL were evaluated 24 hours before PVP, and at 24 hours, 1 month, 3 months, 6 months, 12 months after PVP. SREs were assessed for 12 months postintervention. Results: The mean visual analog scale pain scores decreased significantly from 7.6±1.9 at 24 hours before PVP to 3.6±1.4 post intervention at 24 hours, 2.0±1.5 at 1 month, 2.8±1.6 at 3 months, 3.1±0.8 at 6 months and 2.5±0.9 at 12 months (P＜0.05). The Karnofsky Performance Scale scores for QoL increased significantly after the combination treatment (P＜0.05). Compared with previous studies without the treatment of PVP or ZA, this patient group showed a lower incidence of SREs. No major complications were observed. Conclusions: PVP combined with ZA were shown to be a highly effective and safe combination therapy to relieve pain and improve QoL in patients with breast cancer osteolytic spinal metastases. The combination therapy also showed an ability to prevent the occurrence of SREs.