[Percutaneous verterbreplasty combined with radiotherapy treating malignant vertebrate metastasis].

OBJECTIVE: To evaluate retrospectively the treatment effects and side effects of malignant vertebrate metastasis who had received radiotherapy or percutaneous verterbreplasty (PVP) or PVP combined with radiotherapy. METHODS: Two hundred and sixty-three patients who had been diagnosed as malignant tumor with vertebrate metastasis received PVP (87 patients) or radiotherapy (111 patients) or PVP combined with radiotherapy (65 patients). Radiotherapy was done one week after PVP procedure in PVP combined with radiotherapy group. All patients received regular follow-up. The changes of pain scale were analyzed by NRS. The improvement of quality of life was evaluated by inquiry questionnaire of EORTC QLQ-C30. The side effects were also observed. RESULTS: All defects in vertebrate metastasis in PVP treating were fully filled by polymethylmethacrylate (PMMA) under CT examination. The NRS number decreased significantly after 6 hours after treating in PVP Group and PVP combined with radiotherapy Group (P < 0.01), which shows basement of pain was rapid. The NRS number decreased significantly after one month after treating in radiotherapy Group (P < 0.01), which shows basement of pain was slow. The score of EORTC QLQ-C30 inquiry questionnaire in three Groups reduced, which indicated that the quality of life had been improved. In PVP Group and PVP combined with radiotherapy Group, the score of EORTC QLQ-C30 changed most significantly (P < 0.01). There were no severe clinical complications. CONCLUSIONS: It is safe and effective to treat malignant tumor patients with vertebrate metastasis by PVP combined with radiotherapy and quality of life had been improved significantly with long catabasis.

[Effect of transcatheter renal arterial embolization combined with cryoablation on regulatory CD4+ CD25+ T lymphocytes in the peripheral blood of patients with advanced renal carcinoma].

OBJECTIVE: To analyze the effect of Argon-Helium cryosurgery (AHCS) combined with transcatheter renal arterial embolization (TRAE) on the differentiation of regulatory CD4+ CD25+ T cell (Treg) and its implication in patients with renal carcinoma. METHODS: 77 patients were called in the study, and were divided into two groups: TRAE group (n = 45, receiving TRAE only) and TRAE + cryoablation group (n = 32, receiving cryoablation 2-3 weeks after TRAE). The percentage of Treg cells and T lymphocyte subsets (CD3+T, CD4+T, CD8+T, and CD4+T/CD8+ T) in the peripheral blood was measured by flow cytometry before and 3 months after therapy. Meanwhile, the extent of tumor necrosis was measured by MRI or CT 1 month after therapy. RESULTS: The percentages of Treg cells of patients in TRAE + cryoablation group were decreased from 6.6% +/- 1.2% to 3.9% +/- 1.2%, (t = 42.768, P < 0.01), and the percentages of CD3+ T, CD4+ T, CD8+T, NK and CD4+T/CD8+T were significantly increased (P < 0.01). However, among the patients in TRAE group, the percentages of Treg, CD3+ T, CD4+ T, CD8+T, NK and CD4+T/CD8+T were increased (P > 0.05). The tumor necrosis rates of TRAE + cryoablation groups were 57.5%, significantly higher than those of TRAE group, which shows 31.6% (t = 6.784, P < 0.01). The median survival duration of the TRAE + cryoablation group was 20 months, significantly longer than that of the TRAE group (chi(2) = 7.368, P < 0.01). The decreasing extent of Treg cells is correlated with tumor necrosis rates (r = 0.90 P < 0.01) and life time (r = 0.67 P < 0.01). CONCLUSION: The therapy of TRAE combined with cryoablation contributed to reduce the percentage of Treg cells and improve the immune situation of patients with renal cell carcinoma, consequently increase tumor necrosis rate and prolongs the patients' survival duration.