放射性^(125)I粒子植入治疗肿瘤骨转移患者临床疗效评价  

Clinical Efficacy and Prognostic Impact of Radioactive^(125)I Seed Implantation in the Treatment of Patients with Tumor Bone Metastasis

作　　者：倪效波 朱思佳[1] 王真[1] 郝斌[1] 高英[1] 郝宏毅[1] 郝万庆 NI Xiaobo;ZHU Sijia;WANG Zhen;HAO Bin;GAO Ying;HAO Hongyi;HAO Wanqing(People's Hospital of Ningxia Hui Autonomous Region,The Third Clinical Medical College of Ningxia Medical University,Yinchuan 750002,China)

机构地区：[1]宁夏回族自治区人民医院,宁夏医科大学第三临床医学院,银川750002

出　　处：《宁夏医科大学学报》2024年第10期1010-1014,共5页Journal of Ningxia Medical University

基　　金：宁夏自然科学基金项目(2022AAC03391)。

摘　　要：目的探讨放射性^(125)I粒子植入治疗肿瘤骨转移患者的临床疗效。方法选取宁夏回族自治区人民医院2020年5月至2023年6月收治的恶性肿瘤术后骨转移患者42例为研究对象。所有患者均采用^(125)I粒子植入治疗,比较患者近期疗效、术后3个月视觉模拟评分(VAS)及卡氏(KPS)评分改善情况、无进展生存时间(PFS)、总生存时间(OS)、总生存率及不良反应。结果42例肿瘤转移患者的病灶靶区粒子植入中位数26粒;平均匹配周缘剂量(118.75±6.58)Gy,有效率52.38%,局部控制率73.81%;治疗3个月后,VAS评分低于治疗前,疼痛程度轻于治疗前(P均<0.05);KPS评分高于治疗前,功能状态优于治疗前(P均<0.05);随访截止到2023年12月,42例患者最短PFS时间为5个月,最长PFS时间为19个月,中位PFS时间11.56(95%CI:7.2~15.1)个月;中位OS时间21.6(95%CI:15.7~26.8)个月,总生存率为47.62%;术后仅出现针道轻度渗血、低热及局部血肿等轻度不良反应。结论放射性^(125)I粒子植入治疗可提高肿瘤骨转移患者病灶控制率,降低癌痛程度,提高生存质量或改善功能状态,安全可靠。Objective To investigate the clinical efficacy and prognosis of radioactive iodine^(125)I seed implantation in the treatment of patients with bone metastasis.Methods 42 patients with bone metastases after malignant tumor surgery in People's Hospital of Ningxia Hui Autonomous Region from May 2020 to June 2023 were selected.All patients were treated with^(125)I seed implantation.The short-term efficacy,improvement of visual analogue scale(VAS)and Karnofsky score(KPS).3 months after operation,progression free survival(PFS),overall survival(OS),overall survival rate and adverse reactions were compared.Results The median number of target particle implantation was 26 in 42 patients with tumor metastasis.The average matched peripheral dose was(118.75±6.58)Gy,the objective response rate was 52.38%,and the disease control rate was 73.81%.After 3 months of treatment,the VAS score was lower than that before treatment,and the degree of pain was lighter than that before treatment(P all<0.05);KPS score higher than before treatment,and functional status better than before treatment(P all<0.05).The follow-up visit up to December 2023,the shortest PFS time of 42 patients was 5 months,the longest PFS time was 19 months,and the median PFS time was 11.56(95%CI:7.2-15.1)months.The median OS time was 21.6(95%CI:15.7-26.8)months,and the overall survival rate was 47.62%.There were only mild adverse reactions such as slight bleeding of needle path,low fever and local hematoma after operation.Conclusion Radioactive^(125)I seed implantation can improve the lesion control rate of patients with tumor bone metasasis,reduce the degree of cancer pain,improve quality of life or functional status,which is safe and reliable.

关 键 词：^(125)I 恶性肿瘤 骨转移 疼痛 

分 类 号：R730.55[医药卫生—肿瘤]