【摘要】 目的探讨3D打印非共面模板辅助CT引导¹²⁵I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¹²⁵I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¹²⁵I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¹²⁵I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。更多还原

【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-guided¹²⁵I 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 implanted125 I seed implantation under CT guidance assisted by three-dimensional printing noncoplanar 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 was100%, 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 guided¹²⁵I 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.更多还原