放射性^(125)I粒子植入治疗椎体及椎旁肿瘤

^(125)I seeds interstitial brachytherapy for vertebral and paraspinal carcinomas

目的:评价放射性125I粒子组织间永久性植入治疗椎体及椎旁肿瘤的疗效和安全性。方法:对16例椎体及椎旁肿瘤患者(3例原发肿瘤,13例转移瘤)共28个病灶,行CT引导下或者术中125I粒子永久性植入治疗。粒子活度0.5-0.8mCi,每个病灶植入粒子数目7-100颗。肿瘤最小周边剂量(mPD)110-160Gy。术后行质量验证。结果:中位随访时间26.5个月(5-61个月)。疼痛缓解率93.7%。神经功能恢复或者保留率93.75%。1年局部控制率64%,2年局部控制率50%,3年局部控制率32%,5年局部控制率4%。中位局部控制时间32个月。1年生存率73%,2年生存率59%,5年生存率41%。中位生存期36个月。1例患者因肿瘤进展出现截瘫,其余患者未出现明显的不良反应。结论:放射性125I粒子植入术单独或联合手术治疗椎体及椎旁肿瘤安全、不良反应小,耐受性好。临床疗效尚需进一步临床研究证实。

Objective：To investigate the efficacy and safety of ^125I seeds interstitial implantation for vertebral and paraspinal tumors. Methods： Interstitial implantation of ^125I seeds was performed on 16 patients with vertebral and paraspinal tumors （28 lesions including 3 primary lesions and 13 metastatic lesions）. The radioactivity of the ^125I seeds ranged from 0.5 to 0.8mCi,number of the ^125I seeds ranged from 7 to 100,and the minimum peripheral doses （mPD） was 110 - 160Gy. Quality check was carried out after the implantation. Results： The patients were followed up for a median of 26.5 months （5 -61 months）. The rate of pain relief was 93.7%. Local control rates for lyear,2 years,3 years and 5 years were 64%, 50%, 32% and 4%, respectively. The median local control time was 32 months. Overall survival rates for lyear,2 years and 5 years were 73% ,59% and 41% ,respectively. The median survival time was 36 months. Conclusion： Interstitial implantation of ^125I seed combined with or without surgery is safe, minimally invasive and well tolerated for vertebral and paraspinal tumors. The clinical effectiveness needs more trials to confirm.