| Feng Zheng,Zheng Guangjun,Yang Jingkui,Zhang Shengjie,Chai Shude,Wang Junjie.Co-planar template assisted CT guidance on the treatment of spinal metastases with 125I seed implantation[J].Chinese Journal of Radiological Medicine and Protection,2017,37(10):763-766,788 |
| Co-planar template assisted CT guidance on the treatment of spinal metastases with 125I seed implantation |
| Received:March 16, 2017 |
| DOI：10.3760/cma.j.issn.0254-5098.2017.10.008 |
| KeyWords:Spinal epidural metastases 125I seed CT Co-planar template(CPT) |
| FundProject: |
| Author Name | Affiliation | E-mail | | Feng Zheng | Department of Thoracic Surgery, The Second Hospital of Tianjin Medical University, Tianjin 300211, China | | | Zheng Guangjun | Department of Thoracic Surgery, The Second Hospital of Tianjin Medical University, Tianjin 300211, China | | | Yang Jingkui | Department of Thoracic Surgery, The Second Hospital of Tianjin Medical University, Tianjin 300211, China | | | Zhang Shengjie | Department of Thoracic Surgery, The Second Hospital of Tianjin Medical University, Tianjin 300211, China | | | Chai Shude | Department of Thoracic Surgery, The Second Hospital of Tianjin Medical University, Tianjin 300211, China | | | Wang Junjie | Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China | junjiewang-edu@sina.com |
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| Abstract:: |
| Objective To explore the quality control and the short-term curative efficacy of 125I radioactive seeds implantation in the treatment of spinal metastases by using co-planar template(CPT) assisted CT guidance.Method Totally 12 cases of primary tumor were diagnosed by pathology, imaging changes for 16 lesions were consistent with the characteristics of spinal metastatic tumor. The prescription dose (PD) was 80 Gy, seed activity was 1.48×107-2.59×107 Bq(0.4-0.7 mCi). According to preoperative plan, spinal metastases were treated with CPT assisted CT guided 125I radioactive seeds implantation. The distribution of seeds was observed immediately after operation and the dose was assessed. Patients were followed up by CT to determine the change of tumor diameter and evaluate the efficacy. Follow-up time ranged from 3 to 29 months. And the improvement of pain was evaluated by pain grading.Results All of the 16 spinal metastases lesions were successfully implanted by the preoperative planning. After the implantation, quality verification showed the average dose of target region was (209.21±37.16)Gy, D90(115.29±7.87)Gy,D100(76.59±5.53)Gy,V90 (99.30±0.51)%,V100(98.06±1.15)%, conformal index (CI) 0.981±0.012, external index (EI) 0.012±0.007.And the average dose of the spinal cord was (30.47±4.83)Gy. There was no significant difference in the mean dose between the target area and the spinal cord and the preoperative plan (P>0.05). 3 months after surgery, among 16 spinal metastases lesions, complete response (CR) was 18.8% (3/16), PR (partial response) rate 62.5% (10/16), PD(progressive disease) rate 6.25%(1/16),SD(stable disease) rate 6.25%(1/16),effective rate (CR+PR) 81.3%.The were 3 cases in pain complete remission, 7 cases in partial remission, 2 cases in mild remission. The survival time range from 11 to 39 months. The median survival time was 24 months. No radiation damage of spinal cord was found.Conclusions CT guided CPT can be used to control the position and radiation dose of the seeds implantation before the operation, so as to achieve the objective of treating tumor with fewer complications and improvement of patients' tolerance. |
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