放射性125I粒子植入治疗癌痛

目的探讨放射性~(125)I粒子植入治疗癌痛的有效性。方法收集33例肿瘤患者,采用CT引导放射性~(125)I粒子植入术对引起患者疼痛的责任病灶进行治疗。术前利用放射性粒子源植入治疗计划系统(TPS)制定粒子植入计划,术中实时调整手术方案,术后即刻利用TPS进行植入后验证。对所有患者随访6个月,采用CT扫描评价肿瘤局部控制率。采用视觉模拟评分法(VAS)于术前及术后3天、1个月对患者进行疼痛评估,比较VAS评分的变化。分析术中及术后手术相关并发症。结果对33例患者均成功完成手术,患者第2、4、6个月局部控制率分别为27.27%(9/33)、72.72%(24/33)、84.85%(28/33)。33例患者术后VAS评分均有不同程度改善,术后3天VAS评分3.80±1.25,术后1个月为2.25±1.00,二者差异有统计学意义(t=3.53,P0.05)。手术相关并发症主要为疼痛、发热、软组织肿胀、气胸、局部出血。结论对肿瘤患者癌痛责任病灶行放射性~(125)I粒子植入,可有效缓解疼痛,是一种安全、有效的方法。

Radioactive 125I particle implantation in treatment of cancer pain

Objective To explore the effectiveness of radioactive ¹²⁵I particle implantation in treatment of cancer pain. Methods Thirty-three patients with tumour were enrolled, and in all of them ¹²⁵I particle were implanted to treat the responsibility lesion that caused pain by CT-guidance. Brachytherapy planning system (TPS) was used to draw up a preoperative plan. Real-time adjustment was necessary during implantation. Therapeutic effect were verified by TPS immediately after implantation. All patients were followed up for 6 months, and the local control rates of tumor were evaluated by CT scan. The changes of pain scores were compared by visual analogue scale (VAS) before implantation, 3 days and one month after implantation. The occurrence of intraoperative and postoperative complications was analyzed. Results The technical success rate was 100% (33/33) for placement of the ¹²⁵I particle. The local control rates of 2-, 4- and 6-month was 27.27% (9/33), 72.72% (24/33) and 84.85% (28/33), respectively. The VAS scores three days and one month after implantation was 3.80±1.25, 2.25±1.00, respectively, and the difference was statistically significant (t=3.53, P<0.05). Implantation-related complications included pain, fever, soft tissue swelling, pneumothorax, local bleeding. Conclusion The implantation of radioactive ¹²⁵I particle can be used to relieve pain effectively, and is a safe and effective method to treat responsibility lesion in patients with tumour.