CT引导下^(125)I粒子植入近距离治疗骨转移瘤(附24例报告)  

CT-guided percutaneous brachytherapy by ^(125)I implantation for osseous metastatic tumor (report of 24 cases)

作　　者：刘禄明[1] 都基权[1] 魏长虹[1] 冯艳[1] 孙百胜[1] 

机构地区：[1]武警山东总队医院医学影像科,山东济南250014

出　　处：《医学影像学杂志》2008年第2期151-154,共4页Journal of Medical Imaging

摘　　要：目的:探讨CT引导下125I粒子植入对骨转移瘤进行近距离放疗的可行性、安全性及其疗效。方法:24例骨转移瘤患者(26个病灶),术前依据CT图像应用计算机治疗计划系统制定粒子植入计划,按治疗计划在CT引导下穿刺植入125I粒子,粒子植入数量6~40颗(中位数16颗)。植入术后立即CT扫描及2~8个月CT扫描观察粒子在瘤体内的分布、有无并发症发生及疗效。结果:24例患者均成功植入,未见并发症和治疗相关的放射损伤。24h内100%疼痛完全减轻;随诊CT检查示24例的26个病灶中粒子植入后2个病灶消失,18个病灶明显缩小,4个病灶大小无明显变化,只有2个病灶增大。植入术前及植入术后随诊显示病灶平均直径分别为4.39cm和3.14cm(P=0.0059,P<0.05)。结论:CT引导下经皮穿刺125I粒子植入近距离放射治疗骨转移瘤具有微创、安全、高效等优点,可作为骨转移瘤的治疗方法。Objective ：To evaluate the feasibility, safety, and efficacy of CT-guided permanent iedine-125 implantation for patients with osseous metastatic tumor. Methods： Twenty-six lesions in 24 patients with osseous metastatic tumor were treated with CT-guided iodine- 125 permanent with implantation brachytherapy. Based on the CT imaging within before the implantation of the seeds, a computer-based treatment planning system was used to determine the optimal seed distribution. Subsequent CT-guided needle placement and seed implantation were carried out. The number of seeds implanted in lesions was 6 to 40 （median number 28）. Pust-implant CT scans were performed immediately and two to eight months after the implantation in all cases to assess seed distribution, compfication, and curative effect. Results：CT-guided iodine-125 permanent implantation was accompfished smoothly in all eases. This technique offered a better seed placement. No complications and late toxicity related to the implantation were observed. Pain relief was obtained in 24 patients（ 100% ） presenting with pain in 24 hours. Follow-up CT demonstrated that 4 of 26 lesions disappeared completely, 16 lesions diminished, 4 lesions had no significant change in size,and the remaining 2 lesions growed .Mean lesion size of pre-implant and postimplant were 4.39cm and 3.14cm,respectively（ P = 0.0059, P 〈 0.05）. Conclusion： CT-guided iodine-125 permanent implantation is a feasible,effective, and safe method in the treatment of patients with osseous metastatic tumor.

关 键 词：骨转移瘤 近距离放射疗法 放射性粒子 植入 体层摄影术 X线计算机 

分 类 号：R738.1[医药卫生—肿瘤] R815[医药卫生—临床医学]