Résumé
Objective To compare the efficacy of conventional radiotherapy and Tomo radiotherapy com -bined with zoledronic acid in spinal metastase .Methods Seventy -nine patients with spinal metastases in our department of Air Force General Hospital were recruited from January 2011 to December 2012 .All patients were divided into two groups:group A:39 cases were treated with conventional radiotherapy combined with zoledronic ( PTV:30~40 Gy/10~20 f);40 patients with target in target Tomo radiotherapy combined with zoledronic acid were separated into group B(PTV/GTV/40~50 Gy/50~60 Gy/15~20 f).Results The overall following -up rate was 96.2%.The total response rate was 88.61%,the analgesic effect of radiotherapy in group A and group B were 84.62%、92.5%,respectively.The average pain scores were decreased by 2.55 and 3.54 in two gourps u-sing a numerical rating scale;the average pain relieve time were 7.25d and 8.32d,respectively;the median last-ing time of pain relieves were 6.68 and 8.41months;and the pain recurrence rate were 25.81% and 5.41% in corresponding group A and group B .The main acute side effects were hematologic toxicity , in which occurring rates were 12.82%and 12.5%in RTOG gradeⅠ,23.08% and 20%in RTOG grade Ⅱ,2.56% and 2.5% in RTOG gradeⅢ,2.46%and 0%in RTOG grade Ⅳin group A and group B,respectively.There were no signifi-cant differences in pain relief rate ,start-effect time,lasting time and acute side effects between the two different radiotherapy methods .However ,the decreased degree of pain relief and recurrence rate were obviously decreased in group B when compared with group A ,and the differences were statistically significance (P<0.05).Conclu-sion Target in target Tomo radiotherapy combined with zoledronic acid in the treatment of spinal metastasies is safe and effective,mild toxicity,and the degree of pain relief was significantly improved .Moreover,pain recurrence rate is lower than conventional radiotherapy .Hence ,it is worth of recommendation in clinical practice .