【作者】 张开贤； 邢超； 李苓； 张开国； 袁倩倩； 满其荣； 王伟；

【Author】 ZHANG Kai-xian,XING Chao,LI Ling,ZHANG Kai-guo,YUAN Qian-qian,MAN Qi-rong, WANG Wei Department of Oncology,Center People’s Hospital of Tengzhou,Shandong 277500,P.R.China

【机构】 滕州市中心人民医院肿瘤科；

【摘要】 目的:研究椎体转移瘤不同治疗方法的疗效和安全性。方法:对符合入组条件的187例患者采取不同的治疗方法,包括放疗5 2例,总剂量为30Gy,分10次2周完成;经皮椎体成形术（Percutaneousvertebroplasty,PVP）治疗50例,骨水泥（PMMA）用量为2～10ml;125I粒子植入治疗36例,应用TPS制定植入计划,应用剂量体积直方图（D VH）进行计划评估。肿瘤匹配周边剂量为115～145Gy。共植入10～25颗¹²⁵I粒子,活度为0.5～0.8mCi/颗,籽源间距为0.6～1cm;PVP和¹²⁵I粒子植入术结合（简称联合组）治疗49例,PMMA用量为2～6ml,植入10～20颗¹²⁵I粒子。除放疗外,均采用CT引导,单侧或双侧椎弓根及椎体侧旁进针。结果:所有患者均按计划完成治疗,治疗后1 d、1 M、3 M、6M时,联合组疼痛缓解有效率最高,分别达到89.8%、8 7.7%、9 5.9%、9 3.9%;联合组治疗部位椎体塌陷加重或/和发生新的压缩性骨折率最低,6个月时为4.1%。无严重并发症发生。结论:不同类型的椎体转移瘤应采取不同的治疗方法,虽然不同的治疗方法具有不同的特点,但PVP和¹²⁵I粒子植入术结合治疗椎体转移瘤,在疼痛缓解和预防椎体塌陷加重或/和发生新的压缩骨折方面疗效显著,无明显并发症。更多还原

【Abstract】 Objective:To investigate the curative effect and the security about the different ways of cure centrum metastasis.Methods:187 cases had been therapyeby different ways,thereinto 52 cases hand been irradiation by the dosage of 30Gy/10f/2w;50 cases hand been cured by 2～10ml PMMA;36 cases hand been cured by embedment of 125I by CT guide,the number of 125I particles was 10～25,the radioactivity quantum were 0.5～0.8mCi per granule.49 cases hand been cured by 2-6ml PMMA and 10～20 granules 125I particles.All Of the cases had been done by CT guide exception the cases those irradiationed,the passes were the unilateral or double vertebra root and the vertebra.Results:All of the cases had been treatmented according to the plan.The rats of ache catabatic entiretyly or partly were separatly 89.7%、87.7%、95.9%、93.9%after cured 1d、1M、3M、6M by PMMA and embedment of 125I,and the rat of fracture after 6M was 4.1%.There was no serious syndrome.Conclusions.Different ways should be used for different centrum metastasis.Although there were different characteristic by different ways,but it had salience effect about the ache catabatic entiretyly or partly and the fracture in centrum metastasis treatment with PMMA and embedment of 125I,further more,there was no serious syndrome.更多还原