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 June 2006 and April 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 Karnofsky 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.