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中国癌症防治杂志

中国癌症防治杂志 ›› 2020, Vol. 12 ›› Issue (6): 626-631.doi: 10.3969/j.issn.1674-5671.2020.12.06

• 骨肿瘤诊疗专栏 • 上一篇    下一篇

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

  

  1. 110016 沈阳 辽宁省人民医院骨与软组织肿瘤科
  • 出版日期:2020-12-25 发布日期:2021-01-08
  • 通讯作者: 徐绍年， E-mail: drxshn@126.com
  • 基金资助:
    辽宁省自然科学基金项目（20180530008；20170540518）

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

  1. Department of Orthopedic Oncology, the People′s Hospital of Liaoning Province, Shenyang 110016, China
  • Online:2020-12-25 Published:2021-01-08

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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（12 195.60±1 654.78） 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。

关键词: 脊柱转移瘤, 125I放射粒子, 3D打印非共面模板, 疗效

Abstract: 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 (12 195.60±1 654.78) 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 invasive palliative treatment.

Key words: Spinal metastatic tumors, 125I seed, Three-dimensional printing non-coplanar template, Effection

中图分类号: 

  • R738.1