^(125)I粒子植入术治疗转移性骨痛的临床应用

The clinical application of permanent implantation of ^(125)I seeds in treating metastatic bone pain

目的初步探讨放射性粒子植入术治疗骨转移瘤所致骨痛的疗效。方法诊治52例骨转移瘤患者,在CT引导下行^(125)I放射性粒子植入治疗。结果^(125)I放射性粒子植入后,第2天患者疼痛感明显减轻;第5~7天患者胀痛感加重;术后10~30 d患者疼痛逐渐缓解。术后1个月疗效评估:Ⅰ级疼痛缓解率100%,Ⅱ级疼痛缓解率88.9%,Ⅲ级疼痛缓解率92.3%,总有效率93.7%(P<0.05)。对不同疼痛程度患者局部疼痛缓解有效率高,但Ⅱ、Ⅲ级疼痛缓解率无明显差异(P=0.369)。结论^(125)I放射性粒子植入治疗骨转移瘤所致骨痛,治疗时间短、短期内缓解疼痛疗效明显且并发症少。特别对于溶骨型骨转移瘤,其治疗效果较好,在临床保守治疗疼痛控制不理想时,^(125)I放射性粒子植入可作为一种有效的治疗方法。

Objective To make a preliminary investigation of the curative effect of 125I seed implantation in treating bone pain caused by metastatic bone tumors. Methods A total of 52 patients with metastatic bone tumors were enrolled in this study. CT-guided 125I seed implantation therapy was employed in all patients. Results On the second day after 125I seed implantation, the sense of pain was significantly alleviated, and at 5- 7 days after the treatment the distending pain became worse, and the pain gradually relieved at 10- 30 days after the treatment. The curative effect evaluated at one month after 125I seed implantation showed that the pain relief rates of grade Ⅰ , grade Ⅱ and grade Ⅲ were 100%, 88.9% and 92.3% respectively, with a total effective rate being 93.7% （P〈 0.05 ）. The local pain remission rate, regardless the difference of pain degree, was higher in all patients, but the difference in pain relief rate was not significantly obvious between grade Ⅱ group and grade Ⅲgroup （P=0.369）. Conclusion Implantation of 125I seeds can effectively relieve the bone pain caused by metastatic bone tumors ; the treatment time is short, the pain relief is very obvious within short time, and the complications are fewer. This therapy is especially effective for osteolytic bone metastases. 125I seed implantation can be used as an effective treatment when clinical conservative management can not satisfactorily control the pain.