Huang Hai, Xu Shaonian, Du Zhenguang, Li Fusheng, Wang Liang
Department of Orthopedic Oncology, the People's Hospital of Liaoning Province, Shenyang, 110016, China. Eamil:
Department of Orthopedic Oncology, the People's Hospital of Liaoning Province, Shenyang, 110016, China.
Zhonghua Zhong Liu Za Zhi. 2014 Mar;36(3):228-31.
To explore the value of percutaneous vertebroplasty combined with interstitial implantation of ¹²⁵I seeds in the treatment of metastatic thoracolumbar tumors.
Based on the CT images before ¹²⁵I seed implantation, a computer-based treatment planning system (TPS) was used to determine the optimal seed distribution. Under CT guidance and local anaesthesia, ¹²⁵I seeds were implanted into 22 osseous metastatic lesions in 18 patients. Based on the CT images after the implantation, quality check was carried out with TPS. DSA (digital subtraction angiography)-guided vertebroplasty was performed under local anaesthesia, and bone cement was injected into the vertebrae through pedicle of vertebral arch.
All the 18 patients received percutaneous vertebroplasty combined with interstitial implantation of ¹²⁵I seeds. Every vertebra was injected with 2-6 ml bone cement, average 3.5 ml, and was injected with ¹²⁵I seeds 16-34 pills, average 26 pills. At 2-months follow-up, their numerical rating scale (NRS) pain scores were 7.12 ± 1.48 before and 2.26 ± 1.07 after treatment, with a significant difference (P < 0.05).
Percutaneous vertebroplasty combined with interstitial implantation of ¹²⁵I seeds is a minimally invasive procedure with small wound and minor complications, and no need of external radiation therapy. It is effective in the alleviation of pain in metastatic thoracolumbar tumor patients, restrains the tumor growth, and improves the quality of life. It is a promising minimally invasive method in the treatment of metastatic thoracolumbar tumors.
探讨经皮椎体成形术联合¹²⁵I粒子间质植入治疗胸腰椎转移性肿瘤的价值。
根据¹²⁵I粒子植入前的CT图像,使用基于计算机的治疗计划系统(TPS)确定最佳粒子分布。在CT引导和局部麻醉下,将¹²⁵I粒子植入18例患者的22个骨转移病灶。根据植入后的CT图像,用TPS进行质量检查。在局部麻醉下进行数字减影血管造影(DSA)引导下的椎体成形术,通过椎弓根向椎体内注入骨水泥。
18例患者均接受了经皮椎体成形术联合¹²⁵I粒子间质植入。每个椎体注入骨水泥2 - 6 ml,平均3.5 ml,注入¹²⁵I粒子16 - 34粒,平均26粒。随访2个月时,其数字评分量表(NRS)疼痛评分治疗前为7.12±1.48,治疗后为2.26±1.07,差异有统计学意义(P < 0.05)。
经皮椎体成形术联合¹²⁵I粒子间质植入是一种微创方法,创伤小、并发症少,无需外照射治疗。对缓解胸腰椎转移性肿瘤患者的疼痛、抑制肿瘤生长及提高生活质量有效。是治疗胸腰椎转移性肿瘤有前景的微创方法。