放射性^125I粒子植入治疗椎体及椎旁肿瘤

目的：评价放射性^125I粒子组织间永久性植入治疗椎体及椎旁肿瘤的疗效和安全性。方法：对16例椎体及椎旁肿瘤患者（3例原发肿瘤，13例转移瘤）共28个病灶，行CT引导下或者术中^125I粒子永久性植入治疗。粒子活度0．5—0．8mCi，每个病灶植入粒子数目7—100颗。肿瘤最小周边剂量（mPD）110—160Gy。术后行质量验证。结果：中位随访时间26．5个月（5—61个月）。疼痛缓解率93．7％。神经功能恢复或者保留率93．75％。1年局部控制率64％，2年局部控制率50％，3年局部控制率32％，5年局部控制率4％。中位局部控制时间32个月。1年生存率73％，2年生存率59％，5年生存率41％。中位生存期36个月。1例患者因肿瘤进展出现截瘫，其余患者未出现明显的不良反应。结论：放射性^125I粒子植入术单独或联合手术治疗椎体及椎旁肿瘤安伞、不良反席小．耐受性好。临床疗效尚需进一步临床研究证实。

^125I seeds interstitial brachytherapy for vertebral and paraspinal carcinomas

Objective：To investigate the efficacy and safety of ^125I seeds interstitial implantation for vertebral and paraspinal tumors. Methods： Interstitial implantation of ^125I seeds was performed on 16 patients with vertebral and paraspinal tumors （28 lesions including 3 primary lesions and 13 metastatic lesions）. The radioactivity of the ^125I seeds ranged from 0.5 to 0.8mCi,number of the ^125I seeds ranged from 7 to 100,and the minimum peripheral doses （mPD） was 110 - 160Gy. Quality check was carried out after the implantation. Results： The patients were followed up for a median of 26.5 months （5 -61 months）. The rate of pain relief was 93.7%. Local control rates for lyear,2 years,3 years and 5 years were 64%, 50%, 32% and 4%, respectively. The median local control time was 32 months. Overall survival rates for lyear,2 years and 5 years were 73% ,59% and 41% ,respectively. The median survival time was 36 months. Conclusion： Interstitial implantation of ^125I seed combined with or without surgery is safe, minimally invasive and well tolerated for vertebral and paraspinal tumors. The clinical effectiveness needs more trials to confirm.