^(125)I粒子植入治疗骨转移癌疼痛36例观察

Clinical Observation of the Particle of ^(125)I in the Treatment of Pain Caused by Metastatic Bone Cancer

目的探讨CT引导下125I粒子植入对于骨转移癌疼痛的治疗作用。方法 2009年1月-2011年1月共36例骨转移癌疼痛患者,其中男性20例,女性16例;年龄32～78岁,平均(51.9±15.5)岁,均采用CT引导下125I粒子植入术,术前应用治疗计划系统(treatment planning system,TPS)设计处方剂量,在CT引导下将125I植入相应骨转移癌病灶处及病灶边缘。治疗结束后1个月观察患者的疼痛缓解率、患者的活动能力及不良反应。结果全部患者均能耐受CT引导下125I粒子植入术,治疗后1个月疼痛缓解总有效率达94.4%,其中66.7%的患者疼痛能完全消失;活动能力改善总有效率94.4%,明显改善达61.1%;4例患者出现低热,2例出现低钙血症,经对症治疗均缓解,所有患者未出现放射性损伤症状,无粒子迁移发生。结论 CT引导下125I粒子植入治疗骨转移癌疼痛疗效确切,且副反应低,耐受性好,并发症少,临床值得推广。

Objective To research the value of CT-guided 125I seeds implantation in treatment of pain caused by metastatic bone cancer.Methods The retrospective analysis was undertaken in 36 patients,concluding male 20 cases,female 16 cases,aging 32 to 78（51.9±15.5）,with pain caused by metastatic bone cancer from Jan.2009 to Jan.2011.All patients were implanted with 125I seeds guided by CT.The implantation was according to treatment planning system（TPS） and the seeds were put into the tumors or the edge of the tumors.To appraise the therapeutic effect pain remission rate,locomotor activity and adverse effect after 1 month were observed.Results All the patients can tolerate the CT-guided implantation of the particle of 125I.The total effective rate of pain remission was 94.4% after 1 month,and 66.7% patients felt no pain.The total effective rate of locomotor activity improved was 94.4%,61.1% was improved markedly.4 patients had low fever and 2 patients had hypocalcemia,all symptoms were relieved by symptomatic treatment.None of the patients showed radiation injury and particle migration.Conclusion CT-guided implantation of the particle of 125I was effective and safe to relieve pain from metastatic bone cancer with few complications and good compliance,it should be popularized in clinic.