CT引导下经皮穿刺125I粒子植入治疗脊柱转移瘤

摘要

目的 探讨CT引导下经皮穿刺125I粒子植入治疗椎体转移瘤的有效性及安全性.方法 对20例(23个病变椎体)伴脊髓压迫且有严重腰背部疼痛的椎体转移瘤患者行CT引导下经皮穿刺125I粒子植入治疗.评价术前及术后患者顽固性疼痛情况、神经功能改善情况,计算术后肿瘤局部控制率、患者生存率.结果 20例患者随访时间为7～32个月,中位随访时间14个月,随访期间无失访,未出现严重并发症.术后1个月患者顽固性疼痛较术前明显缓解.12例术前存在神经功能损伤的患者术后3个月神经功能保留率85.00％(17/20),神经功能恢复率30.00％(6/20).术后3、6、12个月肿瘤局部控制率分别为100％、100％、90％,术后6个月和12个月生存率分别为100％和78.81％.结论 CT引导下经皮穿刺125I粒子植入治疗脊柱转移瘤安全、可行,可有效缓解疼痛、改善患者神经功能.%Objective To evaluated the safety and clinical efficacy of CT-guided percutaneous radioactive 125I seeds implantation in treatment of spinal metastatic tumors.Methods Totally 20 cases (23 lesions) of spinal metastatic tumors with spinal compression and severe back pain were treated by CT-guided percutaneous 125I seeds implantation.Intractable pain and nerve function before and after therapy were evaluated.And the postoperative cumulative local tumors control rates and cumulative survival rates were calculated.Results The median follow-up period was 14 months (range 7-32months).There was no patient lost follow-up.And no severe complication occurred.Intractable pain significantly relieved one month after therapy.The neural retention rate of 12 patients with nerve function impairment was 85.00％ (17/20) and the neural function recovery rate was 30.00％ (6/20) three months after 125 I seeds'implantation.The local tumors control rates in 3-,6-,and 12-month were 100％,100％ and 90％,respectively.The survival rates in 6-and 12-month was 100％and 78.81％,respectively.Conclusion CT-guided percutaneous radioactive 125I seeds implantation for spinal metastatic tumors is safe and feasible.It can relief pain and improve neural function effectively.