脊柱软骨肉瘤术后复发CT引导下放射性^(125)I粒子植入的初步观察

Radioactive iodine-125 seed implantation under CT guidance in the treatment of recurrent spinal chondrosarcoma after surgery

目的评价脊柱软骨肉瘤术后复发CT引导下放射性^(125)I粒子植入的初步结果。方法采用CT引导放射性^(125)I粒子植入的方法对5例脊柱软骨肉瘤术后复发患者进行治疗,术前应用三维治疗计划系统制定粒子分布计划,术中间距0.5～1.0cm植入粒子,距离危险器官的安全距离大于1.0cm,术后进行质量验证。结果本组平均随访时间15.2个月(2-41个月),局部有效率60.0%。平均局部控制时间11.4个月,1年局部控制率60.0%。平均生存期15.2个月,1年生存率为66.7%。术前和术后NRS评分分别为6.00±2.65分和1.00±1.00分,二者差异有显著性(P值<0.05),镇痛有效率100.0%。结论 CT引导下放射性^(125)I粒子植入治疗脊柱软骨肉瘤术后复发病例效果确切,疼痛缓解满意,临床应用价值较高。

Objective To evaluate the preliminary clinical outcome of CT-guided radioactive iodine-125 seed implantation in the treatment of recurrent spinal chondrosarcoma after surgery. Methods 5 cases were included in this study. TPS was used to formulate the seeds distribution preoperatively. Seeds were spaced at 0.5cm to 1.0cm intervals. At least 1.0cm was kept apart from the areas at risk, and quality verification was conducted after implantation. Results The median time of follow-up was 15.2 months （range; 2-41 months）. The local control rate was 60.0%. The mean local control time and survival time were 11.4 months and 15.2 months respectively. The local control and survival rates in one year were 60.0% and 66.7% respectively. The mean preoperative and postoperative NRS were 6.00~2.65 and 1.00~：1.00 respectively, and significant differences existed （P〈0.05）. Pain relief ratio was 100.0%. Conclusions CT-guided radioactive iodine-125 seed implantation in the treatment of recurrent spinal chondrosarcoma after surgery is effective, can get satisfied pain relief, and shares high value in clinical application.