放射性碘125粒子治疗脊柱旁转移癌

The Observation of ^(125)I Seeds Implant Treating Spinal Metastatic Carcinoma

目的:CT引导下放射性碘125粒子植入组织间近距离治疗脊柱转移瘤的技术可行性、近期疗效及副反应。方法:10例脊柱旁转移癌患者,局部麻醉,术前行CT扫描,层厚5mm,将图象传送到计算机治疗计划系统,行三维治疗计划。治疗靶体积(PTV)为临床靶体积(CTV)外放1mm,粒子活度0.5mci^0.7mci。肿瘤匹配周边剂量为115~145GY。结果:10例患者均成功完成植入术,平均历时3~5h。粒子植入数目为10~88棵。中位粒子数29颗。8例患者疼痛缓解率100%,疼痛完全缓解率89%,肿瘤1年局部控制率70%。无临床相关并发症。结论:经CT引导下放射性粒子碘125组织间近距离治疗脊柱旁转移癌具有微创、安全、并发症发生率低等特点,可以作为姑息治疗脊柱旁转移癌的方法。

Objective： To observe the feasibility near efficiency and side-effect of adopt ^125I radioactivity seeds implant under CT direct. Method： 10 patients with spinal metastatic carcinoma , using local anesthesia, we use CT scan before operation . every section 5mm,then we transmit it to computer theraputic plan system and formulate 3-dimensional radiotheraputic plan. plan tumor volume （ PTV ） is beyond clinic tumor volume （ CTV ）1mm. seeds activity 0.5mci-0.7mci. Tumor matching periphery dosage 10-88 grains and midian seeds number 29 . 8 patients complete remission in pain. Remission rate 89% and 1 year tumor control rate 70%. there are no clinical complications. Conclusion： ^125I seeds imgration under CT -direct is a short ＂distance-radiotheraputic mean to deal with metastatic carcinoma of spinal. The characteristic is rain- trauma,safety,low complication. We can use itpalliate pain of spinal metastatic carcinoma.