3D打印非共面模板辅助CT引导125 I放射粒子植入治疗脊柱转移瘤的临床应用  

CT-guided 125I seed implantation assisted by 3D printing non-coplanar templates in the treatment of spinal metastatic tumors:A clinical application

作　　者：黄海[1] 王亮[1] 杜振广[1] 李福生[1] 李光帅 张晶[1] 周志成 徐绍年[1] HUANG Hai;WANG Liang;DU Zhenguang;LI Fusheng;LI Guangshuai;ZHANG Jing;ZHOU Zhicheng;XU Shaonian(Department of Orthopedic Oncology,the People′s Hospital of Liaoning Province,Shenyang 110016,China)

机构地区：[1]辽宁省人民医院骨与软组织肿瘤科,沈阳110016

出　　处：《中国癌症防治杂志》2020年第6期626-631,共6页CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT

基　　金：辽宁省自然科学基金项目(20180530008,20170540518)。

摘　　要：目的探讨3D打印非共面模板辅助CT引导125 I放射粒子植入治疗脊柱转移瘤的临床疗效。方法回顾性分析2017年3月至2019年3月于辽宁省人民医院接受3D打印非共面模板辅助CT引导125 I放射粒子植入治疗的脊柱转移瘤患者,评估90%靶区所接受的剂量(D90)、100%处方剂量的体积百分比(V100)、150%处方剂量体积百分比(V150)等参数,评价粒子植入质量,并观察术后并发症及生存情况。结果15例患者均成功进行了3D打印非共面模板辅助CT引导行125 I放射粒子植入,平均放射粒子活度为(0.68±0.10)mCi,平均D90为(12195.60±1654.78)cGy,平均V100为(91.69±2.25)%,平均V150为(61.75±11.67)%。术后6个月,疾病控制率为100.00%,客观缓解率为73.33%。中位局部无进展生存时间为17.00个月(95%CI:13.42~20.58个月),中位总生存时间为17.00个月(95%CI:13.42~20.58个月)。术后6个月NRS评分低于术前[(2.27±1.28)分vs(5.00±1.51)分),P<0.001],而KPS评分高于术前[(86.00±12.42)分和(72.67±11.00)分,P<0.001]。术前至术后6个月,ASIA分级C级变为D级,C级变为E级,D级变为E级各1例。结论3D打印非共面模板辅助CT引导125 I放射粒子植入治疗脊柱转移瘤能有效控制局部病灶,明显缓解疼痛及部分神经损伤,且并发症少见,是一种安全、有效的微创姑息性治疗手段。Objective To investigate the clinical efficacy of CT-guided 125I seed implantation assisted by three-dimensional printing non-coplanar templates in the treatment of spinal metastatic tumors.Methods A retrospective analysis was performed on patients who underwent CT-guided 125I seed implantation assisted by three-dimensional printing non-coplanar templates in the People′s Hospital of Liaoning Province for the treatment of spinal metastatic tumor from March 2017 to March 2019.Parameters such as the dose received at 90%target area(D90),the volume percentage of 100.00%prescription dose(V100)and the volume percentage of 150%prescription dose(V150)were evaluated for seed implantation quality,and postoperative complications and survival were also observed.Results All the 15 patients were successfully implanted 125I seed implantation under CT guidance assisted by three-dimensional printing non-coplanar templates.The average activity of radioactive particles was(0.68±0.10)mCi,the average D90(12195.60±1654.78)cGy,the average V100(91.69±2.25)%,and the average V150(61.75±11.67)%.Six months after the operation,the disease control rate was 100%,and the objective remission rate was 73.33%.The median local progression-free survival time was 17.00 months(95%CI:13.42-20.58 months),and the median total survival time 17.00 months(95%CI:13.42-20.58 months).6 months after operation,NRS score was lower than preoperative[(2.27±1.28)points vs(5.00±1.51)points,P<0.001],while KPS score was higher than preoperative[(86.00±12.42)points and(72.67±11.00)points,P<0.001].From preoperation to 6 months after operation,ASIA grade was changed from grade C to grade D,from grade C to Grade E,and from grade D to Grade E in each case.Conclusions CT guided 125I seed implantation assisted by three-dimensional printing non-coplanar template in the treatment of spinal metastatic tumor can effectively control local lesions,significantly alleviate pain and partial relief of nerve injury,and complications are rare.It is a safe and effective minimally

关 键 词：脊柱转移瘤 125I放射粒子 3D打印非共面模板 疗效 

分 类 号：R738.1[医药卫生—肿瘤]