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目的探讨放射性~(125)I粒子植入近距离治疗长骨转移瘤的临床疗效。方法回顾性收集18例(23处长骨转移病变)长骨转移瘤患者的完整临床及影像学资料,23处病变中,位于肱骨者8处,股骨14处,腓骨1处。应用疼痛数字评分(NRS)及美国肌肉骨骼肿瘤学会评分系统标准(MSTS)评分,对术前术后疼痛、功能情况进行评价。结果本组治疗靶区23个,治疗靶区体积(GTV)为(29.25±22.06)cc,植入粒子数27(15,36),粒子活度0.8 m Ci,术后验证剂量D90(11 538.1±1 888.6)c Gy,治疗后随访3~48个月,中位随访时间9个月。NRS评分、M STS评分在3个月随访期内均有改善(P<0.001,P<0.05)。中位生存时间为10个月,6、12、24个月生存率分别为70.8%、41.3%、23.6%。结论放射性~(125)I粒子植入治疗长骨转移瘤能减轻患者局部疼痛,改善患者功能状态,是一种有效的姑息性治疗方法。
Objective To investigate the clinical effect of radioactive (125) I seed implantation in the treatment of long bone metastases. Methods The complete clinical and imaging data of 18 patients with long bone metastases from 23 patients with long bone metastases were collected retrospectively. Of the 23 lesions, 8 were located in the humerus, 14 in the femur and 1 in the fibula. Preoperative and postoperative pain and functional status were evaluated using NRS and MTSS scores. Results Twenty-three target volumes were treated in this study. The therapeutic target volume (GTV) was 29.25 ± 22.06 cc, the number of implanted particles was 27 (15,36), the particle activity was 0.8 m Ci. The postoperative D90 dose was 11 538.1 ± 1 888.6) c Gy, followed up for 3 to 48 months after treatment, the median follow-up time was 9 months. NRS score and M STS score improved at 3 months of follow-up (P <0.001, P <0.05). The median survival time was 10 months, and the survival rates at 6, 12 and 24 months were 70.8%, 41.3% and 23.6%, respectively. Conclusion Radioactive 125 I seed implantation in the treatment of long bone metastases can reduce local pain and improve the functional status of patients. It is an effective palliative treatment.