[1]黄学全,蔡萍,张琳,等.CT引导下125I籽源植入近距离放射治疗多发性椎体转移癌[J].介入放射学杂志,2007,(12):834.
 HUANG Xue-quan,CAI Ping,ZHANG Lin,et al.CT-guided permanent125I seed brachytherapy for vertebral metastatic cancer[J].journal interventional radiology,2007,(12):834.
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CT 引导下 125 I 籽源植入近距离放射治疗多发性椎体转移癌()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2007年12期
页码:
834
栏目:
非血管介入
出版日期:
2007-12-15

文章信息/Info

Title:
CT-guided permanent 125 I seed brachytherapy for vertebral metastatic cancer
作者:
黄学全蔡萍张琳
400038重庆第三军医大学西南医院放射科
Author(s):
HUANG Xue-quanCAI PingZHANG LinCHEN WeiZHU Jie-huiZHANG En-quanWANG Jian.
Department of Radiology,Southwest Hospital,The Third Military Medical University,Chongqing400038,China
关键词:
125 I籽源近距离照射治疗椎体转移癌
分类号:
R739.93
文献标志码:
A
摘要:
目的探讨 125 I籽源植入近距离放射治疗多发性椎体转移患者的价值。方法15例癌症多发椎体转移患者(共43个椎体)进行了CT引导下 125 I籽源植入近距离放射治疗。肺癌术后椎体转移7例,乳腺癌术后椎体转移4例,肝癌术后椎体转移2例,前列腺癌术后椎体转移1例,左肾癌术后椎体转移1例。共43个椎体转移,每例椎体转移数为2~5个。在CT引导下按共轴针法投放籽源,视病变情况采取椎弓根入路、侧方入路、前入路等3种方式将 125 I籽源植入椎体病变区,籽源呈倒V形、X形或平行分布,籽源距椎体后缘3~10mm。125 I籽源总活度由公式(长+宽+高)(cm)/3×5mCi计算或“放射性粒子源植入治疗计划系统”计算获得,单椎体植入剂量8~22mCi。椎旁软组织病变内同时植入 125 I籽源。结果术后随访3~30个月,平均12.3个月,15例患者术后均未出现脊髓、神经损伤等并发症,未出现放射相关不良反应。11个没有疼痛的部位未出现新的疼痛,18/32部位症状体征消失,14/32部位部分消失。最短术后第3天觉得症状已有缓解。影像表现,10例患者29个椎体影像回访,治疗3个月以后7例17个椎体CT可见病灶稳定,边缘形成硬化环。4个椎体病变进展,见硬化环不完整,破坏区有扩大。3例8个椎体MRI显示骨水肿明显减轻,病变区T 2 WI信号减低。结论 125 I籽源植入近距离放射治疗多发性椎体转移癌具有疗效高,创伤小,并发症发生率低等优点,是一种较好的微创治疗方法,不仅适合于未经治疗的患者,也适合于放射治疗后复发的患者,具有较高的耐受性和安全性。

参考文献/References:

[1]Ratliff JK,Cooper PR.Metastatic spine tumors[J].South Med J,2004,97:246-253.
[2]Wise JJ,Fischgrund JS,Herkowitz HN.Complication,survival rates,and risk factors of surgery for metastatic disease of the spine[J].Orthop Clin North Am,2006,37:99-104.
[3]Klish MD,Watson GA,Shrieve DC.Radiation and intensity-modulated radiotherapy for metastatic spine tumors[J].Neurosurg Clin North Am,2004,15:481-490.
[4]Binning MJ,Gottfried ON,Klimo PJr,et al.Minimally invasive treatments for metastatic tumors of the spine[J].Neurosurg Clin North Am,2004,15:459-465.
[5]Sciuto R,Festa A,Rea S.Effects of low-dose cisplatin on 89 Sr therapy for painful bone metastases from prostate cancer:a randomized clinical trial[J].J Nucl Med,2002,43:79-86.
[6]Coleman RE.Bisphosphonates:clinical experience[J].Oncolo-gist,2004,9:14-27.
[7]Bilsky MH.New therapeutics in spine metastases[J].Expert Rev Neurother,2005,5:831-840.
[8]Bagi CM.Targeting of therapeutic agents to bone to treat metasta-tic cancer[J].Adv Drug Deliv Rev,2005,57:995-1010.
[9]Langley SE,Laing RW.Iodine seed prostate brachytherapy:an alternative first-line choice for early prostate cancer[J].Prostate Cancer Prostatic Dis,2004,7:201-207.
[10]Keller B,Sankreacha R,Rakovitch E.A permanent breast seed implant as partial breast radiation therapy for early-stage patients:a comparison of palladium-103and iodine-125isotopes based on radiation safety considerations[J].Int J Radiat Oncol Biol Phys,2005,62:358-365.
[11]Mashayekhi A,Sun H,Uysal Y.Iodine125plaque radiotherapy as salvage treatment for retinoblastoma recurrence after chemo-reduction in84tumors[J].Ophthalmology,2006,113:2087-2092.
[12]Rogers CL,Theodore N,Dickman CA.Surgery and permanent 125 I seed paraspinal brachytherapy for malignant tumors with spinal cord compression[J].Int J Radiat Oncol Biol Phys,2002,54:505-513.
[13]王立华,刘全,王翠英,等.放射性碘125粒子治疗脊柱旁转移癌[J].河北医学,2006,12:399-400.
[14]李鼎锋,崔秋,张平,等.放射性粒子与人工关节复合假体应用于恶性骨及软组织肿瘤的临床观察[J].临床肿瘤学杂志,2005,15:119-121.
[15]李栋,尹芸生,苏钟毅,等.椎体成形术和放射性粒子植入结合治疗椎体肿瘤[J].中国现代医学杂志,2005,19:3018-3020.
[16]杨祚璋,许建波,马世兴,等.脊柱转移癌经皮椎体成形术联合 125 Ⅰ粒子植入治疗[J].中华放射医学与防护杂志,2006,26:178-179.

备注/Memo

备注/Memo:
收稿日期:2007-08-20
更新日期/Last Update: 2007-12-15