[1]陈玉潇,何闯,杨丽,等.CT引导下125Ⅰ粒子植入术治疗肝细胞癌脊柱转移的临床分析[J].第三军医大学学报,2018,40(12):1130-1135.
 CHEN Yuxiao,HE Chuang,YANG Li,et al.Efficacy of computed tomography-guided 125I seed implantation for treatment of vertebral metastasis of hepatocellular carcinoma[J].J Third Mil Med Univ,2018,40(12):1130-1135.
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CT引导下125Ⅰ粒子植入术治疗肝细胞癌脊柱转移的临床分析(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
40卷
期数:
2018年第12期
页码:
1130-1135
栏目:
临床医学
出版日期:
2018-06-30

文章信息/Info

Title:
Efficacy of computed tomography-guided 125I seed implantation for treatment of vertebral metastasis of hepatocellular carcinoma
作者:
陈玉潇何闯杨丽李良山黄学全
陆军军医大学(第三军医大学)第一附属医院放射科
Author(s):
CHEN Yuxiao HE Chuang YANG Li LI Liangshan HUANG Xuequan

Department of Radiology, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China

关键词:
125Ⅰ粒子肝细胞癌脊柱转移
Keywords:
125I seeds hepatocellular carcinoma vertebral metastasis  
分类号:
R730.55;R735.7;R738.1
文献标志码:
A
摘要:

目的探讨CT引导下125Ⅰ粒子植入术治疗肝细胞癌脊柱转移的效果。方法收集2009年12月至2016年6月本科介入病房收治的16例肝细胞癌患者共23处椎体转移病变临床及影像资料,比较患者在CT引导下125Ⅰ粒子植入术前后Karnofsky功能状态评分(KPS)、标准疼痛数字评分(NRS)、美国脊髓损伤协会(American Spinal Injury Association, ASIA)残损分级,评价疗效。治疗后随访12个月,观察局部肿瘤控制率及患者生存情况。结果治疗靶区共23个,处方剂量12 000 cGy,靶区体积(GTV)为(22.9±21.4) cc,植入粒子数为24(5,50)粒,粒子活度0.8 mCi(1 Ci=3.7×1010Bq),术前靶区D90 (12 399.7±837.4) cGy,术后验证靶区D90 (10 506.2±427.1) cGy,KPS、NRS评分在术后3个月均有改善(P<0.01),术后3个月神经功能恢复率60%(3/5)。患者中位生存时间为8个月,局部控制率93.75%,术后3、6、12个月生存率分别为100%、56.2%、12.5%。患者在随访期内均无严重并发症发生。结论CT 引导下125Ⅰ粒子植入术治疗肝细胞癌椎体转移,能显著减轻患者局部疼痛,改善脊柱运动功能,是一种安全、有效的姑息性治疗方法。

Abstract:

ObjectiveTo evaluate the clinical efficacy of computed tomography (CT)guided 125I seed implantation in the treatment of vertebral metastasis of hepatocellular carcinoma. MethodsThe clinical and imaging data of 16 patients with 23 metastatic tumors were collected. All the patients received CT-guided 125I seed implantation, and the patients’ responses were evaluated by comparing the Karnofsky Performance Status (KPS) scores, Numerical Rating Scale (NRS) scores and American Spinal Injury Association (ASIA) scores before and after the implantation. The patients were followed up for 12 months to record the local tumor control rate and the survival time. Results125I seeds were implanted in all the 23 target lesions with a prescribed dose of 12 000 cGy, a mean gross target volume (GTV) of 22.9±21.4 cc, a median number of implanted seeds of 24 (5 to 50), and a seed radioactive activity of 0.8 mCi(1Ci=3.7×1010Bq). The mean D90 of the target area was 12 399.7±837.4 cGy before and 10 506.2±427.1 cGy after the surgery. At 3 months after the surgery, the patients showed significant improvements in both KPS (P<0.001) scores and NRS scores (P<0.01) with a neurological function recovery rate of 60%. The patients had a median survival time of 8 months with a local tumor control rate of 93.75%, and the patients’ survival rates at 3, 6, and 12 months were 100%, 56.2%, and 12.5%, respectively. None of the patients experienced serious complications during the followup. ConclusionCTguided 125I seed implantation is an effective and safe palliative treatment and can effectively relieve the pain and improve the spinal function in patients with vertebral metastasis of hepatocellular carcinoma.

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更新日期/Last Update: 2018-07-03