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| |  DG DISPATCH - ICBM: Cement Filler Prevents Metastatic Bone Breaks By Robert H. Carlson Special to DG News
PARIS, FRANCE -- June 26, 2000 -- Advanced-cancer patients with bony vertebral metastases may have prolonged pain relief and delayed metastatic-tumor growth when the bony lesions are filled with hot plastic cement. Vertebroplasty, as the procedure is called, was the focus of a workshop during the International Congress on Bone Metastases (ICBM), in Paris, France. In this procedure, the surgeon injects an acrylic cement, polymethylmethacrylate (PMMA), into the bone to fill the space left when an osteolytic tumor is removed. The cement hardens within eight minutes. The procedure can be done in conjunction with chemotherapy or with radiotherapy. "In our group, and in many places in France, this is being used because it has many advantages, with limited risks," said Claude Jasmin, MD, Professor of Oncology at the University of Paris and president of the ICBM. "Most of these patients can have prolonged pain relief and good quality of life." Dr. Jasmin said the procedure, also known as cementoplasty, provides a strong mechanical consolidation of the bone, which helps prevent fracture. In addition, the cement sterilizes the tumor site to a great extent, stopping the process of tumor development. "Where the methyl cement goes, it is sure to sterilize the lesion, because the compound is heated and, immediately around the lesion where it is placed, there is sterilization of the cells," Dr. Jasmin said. "If the tumor were left alone it would compromise the nerves and cause fracture." The procedure has been used for several years to fill the lesions left by giant-cell tumors, but only recently is it being used for metastatic tumors, and in vertebral and pelvic sites. Radiation therapy to the metastatic lesion is the more common treatment, but Dr. Jasmin said sterilization of the lesion site with radiation therapy is less certain. In addition, the high radiation doses needed for palliation cause significant side effects for the patient. Side effects are associated with cementoplasty as well, including pain at the injection site, but these diminish within a few days of surgery, Dr. Jasmin said. And, he said, cementoplasty's analgesic effect at the tumor site, and also its antitumor effect, far outweigh the risks.
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