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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 investigate the safety and efficacy of CT guided percutaneous 125I radioactive seed implantation in the treatment of vertebral metastatic tumors. Methods Twenty patients with metastatic tumors of vertebral body, including 9 males and 11 females, were aged from 50 to 79 years with a mean age of 61.1 years. Three-dimensional images of vertebral metastatic tumors were reconstructed using a treatment planning system to calculate the number of 125I radioactive particles implanted and the dose distribution rate. The peripheral dose for tumor matching was 90-130 Gy. CT-guided spine metastatic tumor implantation, a total of 24 vertebral body, the median implantation particles 19 (4 to 43). Retrospective analysis of the therapeutic effect. Results Twenty patients were followed up for 4 to 26 months with a median follow-up of 12 months. Postoperative pain relief rate was 95% (19/20). The local control rate was 80.0% at 6 months and 30.0% at 12 months. The median survival time was 9 months. The cumulative survival rates were 95.0% at 6 months and 45.0% at 12 months. The median survival time was 10 months. Conclusion CT guided percutaneous 125I radioactive seed implantation in the treatment of vertebral metastatic tumors is a relatively safe and effective minimally invasive treatment.