CT引导下125I粒子植入治疗骨转移性肿瘤的临床疗效观察  

Efficacy of computed tomography-guided 125I particle implantation in the treatment of metastatic tumor of bone

作　　者：王莹莹 肖银 冉建波 田福华 张涛[2] WANG Yingying;XIAO Yin;RAN Jianbo;TIAN Fuhua;ZHANG Tao(Department of Oncology,People′s Hospital of Jiulongpo District,Chongqing 400016,China;Department of Oncology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆市九龙坡区人民医院肿瘤科,400016 [2]重庆医科大学附属第一医院肿瘤科,400016

出　　处：《重庆医学》2020年第16期2748-2750,共3页Chongqing medicine

摘　　要：目的探讨CT引导下放射性碘125(125I)粒子植入治疗骨转移性肿瘤的临床疗效及安全性。方法收集2016年1月至2018年12月重庆市九龙坡区人民医院66例进行125I粒子植入治疗的骨转移性肿瘤患者的临床资料,对比分析治疗前、治疗后1个月及3个月骨病灶变化,术前、术后标准疼痛数字评分(NRS)、碱性磷酸酶(AKP)水平及并发症,观察局部肿瘤控制率及临床症状改善情况。结果66例患者中肺癌31例,肾癌5例,前列腺癌及结肠癌各4例,卵巢癌2例,其他癌症20例,共110个骨转移病灶,靶区平均植入粒子数量为(39.8±28.1)粒。所有患者术前均有不同程度的疼痛,NRS评分为(4.05±1.45)分,术后多数患者疼痛明显缓解,NRS评分为(2.03±0.98)分,术前、术后NRS评分比较,差异有统计学意义(P<0.05)。血清AKP水平由术前(132.48±135.44)U/mL降至术后的(112.73±83.77)U/mL,差异有统计学意义(P<0.05);根据局部肿瘤控制及临床症状改善情况,发现完全缓解(CR)11例,部分缓解(PR)39例,未缓解(NC)11例,进展(PD)5例,总有效率75.76%,其中31例肺癌患者的总有效率为87.10%。结论CT引导下125I粒子植入治疗骨转移性肿瘤能有效地局部控制肿瘤并减轻患者局部疼痛。Objective To investigate the clinical efficacy and safety of CT-guided radioactive 125I particle implantation in the treatment of bone metastases tumors.Methods The clinical data of 66 patients with bone metastases treated with 125I particle implantation in People′s Hospital of Jiulongpo District were collected from January 2016 to December 2018.The changes of bone lesions,the numerical rating scale scores(NRS),alkaline phosphatase(AKP)and complications before and after 1 and 3 months of treatment were compared and analyzed.The local tumor control rate and the improvement of clinical symptoms were observed.Results There were 31 cases of lung cancer,5 cases of renal cell carcinoma,4 cases of prostate cancer,4 cases of colon cancer,2 cases of ovarian cancer and 20 cases of other cancers,and contained 110 bone metastatic lesions in all these cases,the average number of particles implanted in the target area was(39.8±28.1)particles.All the patients had different degrees of pain before surgery,the NRS score was(4.05±1.45)points,but most patients had significant pain relief after surgery,the NRS score was(2.03±0.98)points,the difference was statistically significant(P<0.05).The level of AKP decreased from(132.48±135.44)U/mL to(112.73±83.77)U/mL,the difference was statistically significant(P<0.05).According to the local tumor control and the improvement of clinical symptoms,there were 11 cases of CR,39 cases of PR,11 cases of NC,5 cases of PD,and 75.76%of the total effective rate,among which,the total effective rate of 31 cases of lung cancer was 87.10%.Conclusion CT-guided 125I particle implantation can effectively control the tumor and significantly reduce the local pain of the patient in the treatment of bone metastases.

关 键 词：骨肿瘤 肿瘤转移 碘放射性同位素 粒子植入 治疗结果 疼痛 

分 类 号：R730.1[医药卫生—肿瘤]