CT引导下经皮穿刺^(125)I放射性粒子植入治疗椎体转移性肿瘤的临床应用

Clinic efficacy of CT-guided ^(125)I seeds implantation therapy in patients with advanced vertebrae metastatic tumor

目的探讨CT引导下经皮穿刺125I放射性粒子植入治疗椎体转移性肿瘤临床应用的安全性及疗效。方法 20例椎体转移性肿瘤的患者,其中男性9例,女性11例,年龄50～79岁,平均年龄61.1岁。采用治疗计划系统重建椎体转移性肿瘤的三维图像,计算出125I放射性粒子植入的数量和剂量分布率,肿瘤匹配周边剂量为90～130 Gy。CT引导下脊柱转移性肿瘤粒子植入,共24个椎体,中位植入粒子19颗(4～43颗)。回顾性分析治疗效果。结果 20例患者随访4～26个月,中位随访时间12个月。术后疼痛缓解率95%(19/20),局部控制率6个月和12个月分别为80.0%和30.0%。中位生存时间9个月;累计生存率6个月和12个月分别为95.0%和45.0%,中位生存时间10个月。结论 CT引导下经皮穿刺125I放射性粒子植入治疗椎体转移性肿瘤是一种相对安全、有效的微创治疗方法。

Objective To examine the safety and clinical efficacy of CT-guided radioactive ^125I seeds implantation treatment in the patients with vertebrae metastatic tumor. Methods A total of 20 patients with vertebrae metastatic tumor were enrolled, male 9, female 11, aged 50 - 79 years old, mean age 61.1 years old. The treatment planning system（TPS） were performed to reconstruct three-dimensional image of vertebrae metastatic tumor and calculated the number and dose rate distribution of^125I seeds. The matching peripheral dose（MPD） of ^125I seed implantation was 90 - 130 Gy. The 24 vertebrae metastatic tumors were treated by CT-guided radioactive ^125I seeds implantation. The median of 19（range 4 - 43） 125I seeds were implanted, and the treatment effects were retrospectively analyzed. Results The 20 cases were followed up for a median of 12 months（4 - 26 months）. The rate of pain relief was 95 %. The local control rates of 6 months and 12 months were 80.0 % and 30.0 %, respectively, and the median local control time was 9 months. The overall survival rates of 6 months and 12 months were 95.0 % and 45.0 %, respectively, and the median survival time was 10 months. Conclusion It is demonstrated that the CT-guided radioactive iodine-125 seeds implantation treatment in the patients with vertebrae metastatic tumor is a safe, effective, and minimally invasive method.