摘要
目的脊柱转移瘤患者治疗的目的主要是缓解疼痛、提高生活质量和改善预后等,近距离放射治疗,尤其是^(125)I粒子治疗脊柱转移瘤显示出较大的优势。本研究通过总结近年来针对^(125)I粒子治疗脊柱转移瘤的作用机制、对人体及周围组织的影响、临床应用的相关研究,为脊柱转移瘤的治疗提供参考。方法应用PubMed、CNKI数据库、万方数据库、维普中文科技期刊数据库、中国生物医学文献数据库系统,以"^(125)I粒子、近距离放疗、分子生物学和脊柱转移瘤"等为关键词,检索2000-01-2016-07的相关文献。纳入标准:(1)^(125)I粒子治疗肿瘤的分子生物学机制;(2)^(125)I粒子植入后对机体及周围组织的影响;(3)^(125)I粒子治疗脊柱转移瘤的临床预后。排除标准:(1)实验设计不合理;(2)非随机对照实验;(3)总样本数或总病例数<15例。根据纳入标准与排除标准,符合分析的文献39篇。结果 ^(125)I粒子近距离放疗可以有效地杀伤肿瘤细胞,对机体重要脏器功能及脊髓神经的功能无显著性影响,并可有效缓解神经性疼痛。肿瘤靶区的辐射剂量高,^(125)I粒子治疗脊柱转移瘤,有较高的肿瘤局部控制率,疼痛缓解效果明显,可缓解脊髓压迫症状;^(125)I粒子植入联合椎体成形术治疗脊柱转移瘤还可进一步增加疼痛缓解率并恢复了脊柱稳定性,有叠加效应及优势互补作用;脊柱转移瘤溶骨性破坏累及小关节导致脊柱不稳以及出现较为严重的脊髓神经压迫症状的患者,可采用^(125)I粒子植入联合手术治疗,这是一种具有微创、安全、有效及并发症发生率低等优点的治疗方法,可有效地缓解疼痛、改善脊髓神经功能、局部肿瘤控制及重建脊柱稳定性。结论与传统放射治疗相比较,^(125)I粒子近距离放射治疗具有较大的优势,为脊柱转移瘤的治疗提供了新思路。但仍需要进一步地研究,提高脊柱转移瘤的治疗疗
OBJECTIVE The primary therapy for spinal metastases patients is to relieve the pain,improve quality of life and the prognosis.Brachytherapy,especially ^(125)I seeds for treating spinal metastases showed a greater advantage.This paper summarized the recent researches of the ^(125)I Particle Therapy in the mechanisms of spinal metastases,the impact on the human body and the surrounding tissues and the related clinical applications for the treatment of spinal metastases.METHODS Relevant articles were searched with'^(125)I seed,brachytherapy,molecular biology,spinal metastases,et al'as keywords in pubmed,CNKI,Wanfang,VIP,CBD database from 2000 to 2016.Totally 39 papers were selected and analyzed according to the inclusion criteria as follows:the molecular biology mechanisms of ^(125)I seeds for treating cancer,the effect of ^(125)I seeds implantation on body and surrounding tissue,the ^(125)I seeds implantation for treating spinal metastases' efficacy and prognosis,and the exclusion criteria are as follows:the experimental design is unreasonable,non-randomized controlled trials,the total number of samples or the total number of cases is less than 15 cases.RESULTS ^(125)I seeds brachytherapy can effectively kill tumor cells,the organ function of vital organs and spinal cord nerve function had no significant effect,and can effectively relieve neuropathic pain.^(125)I seeds in the treatment of spinal metastases,a higher local control rate of the tumor,pain relief effect is obvious,can relieve spinal cord compression symptoms;^(125)I seeds implantation combined with vertebroplasty in the treatment of spinal metastases can also be Further increase the rate of pain relief and restore the stability of the spine,a superposition effect and complementary advantages.Spinal metastases osteolytic destruction involving the small joints leading to spinal instability and the emergence of more severe symptoms of spinal cord compression in patients with ^(125)I seeds can be combined with surgical treatment,is a minimally invasive,safe
出处
《中华肿瘤防治杂志》
CAS
北大核心
2016年第20期1392-1397,共6页
Chinese Journal of Cancer Prevention and Treatment
