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山东大学学报（医学版） ›› 2017, Vol. 55 ›› Issue (2): 50-54.doi: 10.6040/j.issn.1671-7554.0.2016.1239

• 放射性粒子植入治疗肿瘤专题 • 上一篇    下一篇

放射性125I粒子植入近距离治疗长骨转移瘤的临床疗效

李扬,何闯,陈玉潇,杨丽,李良山,李廷源,黄学全   

  1. 第三军医大学西南医院介入科, 重庆 400038
  • 收稿日期:2016-09-30 出版日期:2017-02-10 发布日期:2017-02-10
  • 通讯作者: 黄学全. E-mail:hxuequan@163.com E-mail:hxuequan@163.com
  • 基金资助:
    重庆市科技攻关计划(cstc2012gg-yyjs10049)

CT-guided interstitia 125I seed implantation in the treatment of long bone metastasis: a primary clinic study

LI Yang, HE Chuang, CHEN Yuxiao, YANG Li, LI Liangshan, LI Tingyuan, HUANG Xuequan   

  1. Department of Intervention, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
  • Received:2016-09-30 Online:2017-02-10 Published:2017-02-10

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摘要： 目的 探讨放射性125I粒子植入近距离治疗长骨转移瘤的临床疗效。 方法 回顾性收集18例(23处长骨转移病变)长骨转移瘤患者的完整临床及影像学资料,23处病变中,位于肱骨者8处,股骨14处,腓骨1处。应用疼痛数字评分(NRS)及美国肌肉骨骼肿瘤学会评分系统标准(MSTS)评分,对术前术后疼痛、功能情况进行评价。 结果 本组治疗靶区23个,治疗靶区体积(GTV)为(29.25±22.06)cc,植入粒子数27(15,36),粒子活度0.8 mCi,术后验证剂量D90(11 538.1±1 888.6)cGy,治疗后随访3~48个月,中位随访时间9个月。NRS评分、MSTS评分在3个月随访期内均有改善(P<0.001, P<0.05)。中位生存时间为10个月,6、12、24个月生存率分别为70.8%、41.3%、23.6%。 结论 放射性125I粒子植入治疗长骨转移瘤能减轻患者局部疼痛,改善患者功能状态,是一种有效的姑息性治疗方法。

关键词: X线计算机, 放射性125I粒子, 体层摄影术, 长骨转移瘤, 近距离治疗

Abstract: Objective To evaluate the clinical efficacy of the implantation of 125I radioactive seeds in the treatment of long bone metastasis. Methods The clinical data of 18 cases were collected along with their imaging data. The lesions located in the humerus(n=8), thighbone(n=14), and fibula(n=1). The patients pain was observed by using the numerical rating scale(NRS), and the functions of patients were investigated with the Musculoskeletal Tumor Society(MSTS)scoring system before and after surgery. The survival rate was described with Kaplan-Meier survival curve. Results All of the 23 radiotherapy targets were implanted with 125I seeds. The gross tumor volume(GTV)was(29.25±22.06)cc, and the radioactive activity of seed was 0.80 mCi. Median number of seeds implanted in lesions was 27(15, 36). The postoperative target verified dose D90 was(11 538.1±1 888.6)cGy. The mean follow-up was 9 months(ranging from 3 to 48 months).The NRS and MSTS scores were both improved significantly during the follow-up(P<0.001, P<0.05). Medium survival time was 10 months, while the survival rate for 6, 12 and 24 months was 70.8%, 41.3% and 23.6%, respectively. Conclusion CT-guided 125I seed implantation is an effective and safe palliative care for long bone metastasis, which can effectively relieve the pain and improve the functions of patients.

Key words: 125I radioactive seeds, Brachytherapy, Long bone metastasis, X-ray computed, Tomography

中图分类号: 

  • R739.93
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