125I粒子组织间植入治疗骨转移瘤的临床研究

目的评价125I粒子组织间植入治疗骨转移瘤的疗效和安全性.方法对28例骨转移瘤患者共34个病灶,根据CT图像应用计算机治疗计划系统制定粒子植入计划,按计划在CT引导下进行125I粒子组织间植入治疗,术后将X线片和CT扫描图像输入治疗计划系统进行质量验证.观察术后疼痛缓解情况和局部病灶的影像学变化.结果中位随访时间13.5个月(2-21个月).术后2个月对125I粒子组织间植入治疗骨转移瘤的疗效进行评价.患者疼痛评级明显降低(P＜0.01),疼痛缓解率为89.2%,其中显效13例、有效12例,无效3例;局部病灶控制率为91.1%,1年局部病灶控制率为66%.所有患者未出现严重的不良反应.结论对不适合手术的恶性肿瘤骨转移患者行125I粒子植入治疗可以延缓肿瘤生长、缓解疼痛、提高患者的生活质量,是一种有应用前景的方法.临床疗效和安全性尚需进一步研究证实.

Interstitial 125I seeds implantation in the treatment of osseous metastasis

Objective To investigate the efficacy and safety of interstitial ^125I seeds implantation in the treatment of osseous metastasis. Methods Based on the CT image before the implantation of the seeds, a computerbased treatment planning system （TPS） was used to determine the optimal seeds distribution. Under CT guidance, ^125I seeds were implanted into 34 osseous metastasis lesions of 28 patients. Based on the X-ray and CT image aRer the implantation, quality check was carried out with TPS. The ostalgia- relieving degree and the image alterations of the osseous metastasis lesions were observed. Results The patients were followed up for a median of 13.5 months （2-21 months）. Two months after the implantation, the pain grade decreased significantly （P〈0.01）. The rate of pain relief was 89.2%. It took effect in 13 cases, was effective in 12 cases, and noneffective in 3 cases. Local control rate was 91.1% and the local control rate for one year was 66%. No serious side-effect happened to the patients. Conclusions Interstitial implantation of ^125I seeds is a good alternative method for patients who are not suitable for operation. It can restrain the growth of tumor, relive pain, and improve life quality. It is a prospective method in the treatment of osseous metastasis. The efficacy and safety need more clinical trials to confirm.