椎体成形术联合^(125)I粒子植入治疗脊椎转移癌的实验研究——骨水泥对粒子射线的影响  

Experimental study of percutaneous vertebroplasty combined with ^(125)I seeds implantation in treating spinal metastatic tumor: the effect of bone cement on particle radiation

作　　者：吴梅祥[1] 陈翠玲[2] 符乙敏 郭倞[1] 尹知训[1] 何二兴[1] 陈萍[3] 白波[1] WU Meixiang;CHEN Cuiling;FU Yimin;GUO Jing;YIN Zhixun;HE Erxing;CHEN Ping;BAI Bo(Department of Orthopaedics,The First Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong 510120,China)

机构地区：[1]广州医科大学附属第一医院骨科,510120 [2]广州医科大学附属第一医院手术室,510120 [3]广州医科大学附属第一医院核医学科,510120

出　　处：《中国骨科临床与基础研究杂志》2017年第5期305-309,共5页Chinese Orthopaedic Journal of Clinical and Basic Research

基　　金：广东省科学技术厅社会发展领域科技计划项目(2013B021800319)

摘　　要：目的探讨^(125)I粒子骨水泥(PMMA)包裹后表面放射活度的变化,观察骨水泥对粒子射线的影响,为椎体成形术联合^(125)I粒子植入治疗脊柱转移癌提供实验依据。方法分别制作A、B两组不同厚度骨水泥包裹^(125)I粒子的圆柱体模型,其中A组高2.0 cm、直径2.0 cm,B组高1.0 cm、直径1.0 cm,每组各5个模型。检测粒子包裹前表面总放射活度,骨水泥未凝固前于10个实验模型中心部各植入4枚^(125)I粒子,观察各模型表面放射活度的变化,分析骨水泥对^(125)I粒子射线的影响。结果 A组^(125)I粒子包裹前、包裹后表面放射活度分别为(2.379±0.075)、(0.013±0.001)mCi,B组为(2.388±0.045)、(0.022±0.002)m Ci。两组包裹前表面放射活度相似(P>0.05),骨水泥包裹后均明显降低(P<0.05),说明两组模型骨水泥对粒子射线均产生阻挡作用,其中A组模型(直径2.0 cm)表面放射活度较B组模型(直径1.0 cm)下降得更快(P<0.05),阻挡效应更明显。结论PMMA骨水泥对包裹于其内的^(125)I粒子会产生明显的阻挡效应,这种阻挡效应随着骨水泥厚度的增加而逐渐加强,提示椎体成形术联合^(125)I粒子植入治疗脊柱转移癌过程中,应考虑植入粒子与骨水泥填充区域的位置关系,尽可能降低骨水泥对粒子射线的影响。Objective To explore the surface radioactivity changes of 125I seeds embedded in bone cement(polymethylmethacrylate,PMMA)and to observe the effect of bone cement on particle radiation,so as to provide experimental evidences for the treatment of spinal metastatic tumor by percutaneous vertebroplasty(PVP)combined with 125I seeds implantation.Methods Ten cylinder models of 125I seeds embedded in bone cement were constructed and divided into group A and group B according to the different thickness of bone cement(n=5),in which group A were cylinders of 2.0 cm in diameter and height,group B were cylinders of 1.0 cm.Total radioactivity of 125I seeds was measured before embedded into bone cement for each model,then four 125I seeds were implanted into the central area in 10 models.Before the solidification of bone cement,changes of radioactivity of 125I seeds for each model were evaluated,and the effect of bone cement on particle radiation was analyzed.Results Total radioactivity of 125I seeds before and after embedded into bone cement was(2.379±0.075),(0.013±0.001)mCi in group A,and(2.388±0.045),(0.022±0.002)mCi in group B respectively.Similar results were found when compared the indicators before embedded into bone cement between two groups.After embedded into bone cement,radioactivity of 125I seeds all decreased in two groups(P<0.05),revealing bone cement in two groups played roles in blocking particle radiation;Furthermore,the barrier effect of bone cement in group A(2.0 cm thickness)was more pronounced than that in group B(1.0 cm thickness),with significant differences when compared two groups(P<0.05).Conclusion Bone cement(PMMA)would trigger blocking effect when 125I seeds are embedded in,which could be enhanced followed with the increase of the thickness of bone cement,indicating that position relationship between 125I seeds placement and bone cement filling should be considered,with the aim of reducing the influence of bone cement on particle radiation as far as possible during PVP combined with 125I seeds imp

关 键 词：椎体成形术 脊柱肿瘤 肿瘤转移 碘放射性同位素 近距离放射疗法 骨黏合剂 

分 类 号：R738.1[医药卫生—肿瘤] R687.3[医药卫生—临床医学]