目的探讨经皮椎体成形术(PVP)联合放射性粒子植入治疗椎体转移癌的有效性和安全性。方法对41例胸腰椎转移癌患者的52个病变椎体,在CT引导下进行经皮椎体穿刺125I粒子组织间植入及骨水泥(PMMA)灌注成形治疗;术后随访1年,应用数字分级法(NRS)观察患者的疼痛缓解程度,EORTC-QLQ-C30问卷调查手术前后生活质量的变化,并观察治疗并发症及1年生存率和局部控制率。结果 41例患者术后1个月疼痛均获不同程度缓解,其中3、4度缓解率为82.9%(34/41);术后EORTC评分较术前明显降低,生活质量显著提高(P<0.05);术后患者6个月内局部控制率为90.2%(37/41),1年生存率为73.2%(30/41);在存活的30例患者中,1年局部控制率为93.3%(28/30);术后有7例出现PMMA向椎体周围组织渗漏,但均无明显临床症状,未出现放疗相关不良反应。结论在CT监视下,应用PVP联合放射性粒子植入治疗椎体转移癌具有稳定椎体和抑制肿瘤的协同作用,并且微创安全,可作为椎体转移癌的有效联合治疗方法之一。 Objective To investigate the efficacy and safety of percutaneous vertebroplasty (PVP) combined with radioactive particle implantation in the treatment of vertebral metastases. Methods Twenty-two lesions of 41 patients with metastatic thoracolumbar metastasis were treated by percutaneous vertebroplasty with 125I interbody interstitial cement and PMMA percutaneous vertebroplasty under CT guidance. One year after operation, The degree of pain relief was observed by grading method (NRS). The quality of life before and after EORTC-QLQ-C30 questionnaire was investigated. The complication, 1-year survival rate and local control rate were also observed. Results The pain relief in 41 patients at one month after operation was relieved to varying degrees, of which the 3, 4-degree remission rate was 82.9% (34/41). The postoperative EORTC score was significantly lower than that before operation and the quality of life was significantly improved (P <0.05 ). The local control rate was 90.2% (37/41) in 6 months after operation, and the one-year survival rate was 73.2% (30/41). Among the 30 surviving patients, the 1-year local control rate was 93.3% (28/30). There were 7 cases of PMMA leakage into the peri-vertebral body after operation, but no obvious clinical symptoms and no radiotherapy-related adverse reactions occurred. Conclusions The application of PVP combined with radioactive particle implantation in the treatment of vertebral metastatic carcinoma has the synergistic effect of stabilizing the vertebral body and inhibiting the tumor under the surveillance of CT, and is safe and minimally invasive. It can be used as an effective combination therapy for vertebral metastases.