CT引导下放射性125I粒子置入治疗脊柱转移性肿瘤的价值

CT-guide interstitial iodine-125 seed implantation for metastatic spine tumor

中文关键词:  CT引导  125I粒子  脊柱肿瘤  转移  近距离治疗

英文关键词:CT-guide  Iodine-125 seed  Spinal tumor  Metastasis  Brachytherapy

中文摘要:

  【摘要】 目的：探讨CT引导下放射性125I粒子置入治疗脊柱转移性肿瘤的价值。方法：14例无法手术切除或放化疗的脊柱转移性肿瘤患者，均在CT引导下行放射性125I粒子置入术。置入术前应用三维治疗计划系统制定粒子置入计划。术中根据CT影像采取不同置入针排列方式种植粒子，粒子间距0.5～1.0cm。根据肿瘤大小及对放射线敏感程度置入粒子数范围26～145颗，粒子活度范围0.50～0.80mCi。术后即刻复查CT观察粒子分布情况，并再次应用三维治疗计划系统进行剂量验证。结果：14例患者均顺利完成手术。所有病例随访1～75个月，中位随访时间12.0个月。局部有效率50.0%，中位局部控制时间为26.0个月，1年、2年和3年局部控制率分别为62.5%、50.0%和37.5%。中位生存时间11.0个月，1年、2年和3年生存率分别为50.0%、41.7%和20.8%。神经功能保留率和恢复率分别为92.9%（13/14）和71.4%（10/14）。镇痛有效率和疼痛完全缓解率分别为78.6%（11/14）和64.3%（9/14）。结论：CT引导下放射性125I粒子置入治疗脊柱转移性肿瘤安全，并发症少，疗效确切，可作为不宜手术切除或放化疗患者的补充治疗方式。

英文摘要:

  【Abstract】 Objective：To investigate the value of CT-guide interstitial iodine-125 seed implantation for metastatic spine tumor.Method：14 patients with metastatic spine tumor，who did not have surgery，chemotherapy or external beam radiotherapy，underwent CT-guide interstitial iodine-125 seed implantation.Three-dimensional treatment system was used to determine the implantation plan.Different needles placement（0.5-1.0cm apart），number and distribution of seeds were determined according to the images，tumor sizes and sensitivity to radioactive rays. The mean number of seeds was 72（range，26-145），and the mean radioactive activity was 0.70mCi（range，0.50-0.80mCi）.Three-dimensional treatment system was used for dose validation.Result：The mean follow-up was 12.0 months （range，1 to 75 months）.The local control rate was 50.0%.The mean local control time and survival time was 26.0 months and 11.0 months repectively.The 1-year，2-year and 3-year local controls were 62.5%，50.0% and 37.5% respectively.The 1-year，2-year and 3-year survival rates were 50.0%，41.7% and 20.8% respectively.Preservation and recovery ratio of meurofunction were 92.9% and 71.4% respectively.Effect and complete pain relief ratio were 78.6% and 64.3% respectively.Conclusion：CT-guide interstitial iodine-125 seed implantation is minimally invasive and less-complication for spine metastatic tumor，which can be used as an alternative to convention surgery.