摘要
目的探讨放射性125I粒子植入治疗口腔癌的短期疗效和不良反应及生存率。方法 2008年9月至2012年4月共18例口腔癌患者,行125I放射性粒子植入术,术前采用治疗计划系统(TPS)计算术中所需125I粒子数量、粒子布源情况、进针方向。在螺旋CT导向下将125I放射性粒子植入肿瘤靶区和外周0.5 cm,粒子间距0.5~1 cm,粒子活度0.60~0.80 mCi(2.22×107~2.96×107Bq)。术后即刻行CT扫描,层厚2 mm,将图像传送到计算机TPS进行质量验证。其中6例有颈部淋巴结转移,对其用同法行125I粒子植入。治疗2个月后评价近期疗效,观察术中、术后不良反应及术后每3个月随访1次。结果治疗后溃疡病灶逐渐有不同程度缩小或消失,疼痛逐渐减轻;治疗6个月后原发灶近期疗效CR为50.0%,PR为38.9%,有效率为88.9%。转移颈部淋巴结近期疗效CR为70.0%,PR为20.0%,有效率为90.0%。不良反应有术中出血和术后疼痛,所有患者未出现放射损伤症状,未发现粒子迁移。随访9~24个月,其中1、2年累计生存率分别为94.4%、72.2%,中位生存期为18个月。结论放射性125I粒子组织间植入治疗口腔癌是安全、有效的,不良反应轻、并发症少,具有一定的临床应用价值。
Objective To investigate the short-term effect, the adverse effects and the survival rate of braehytherapy with 125I seed implantation for oral cancer. Methods During the period from September 2008 to April 2012, a total of 18 patients with oral cancer were admitted to authors＇ hospital. All patients underwent 125I radioactive seed implantation. Treatment planning system （TPS） was used to calculate the needed number of seeds, the space distribution and the orientation of the puncture needle. Under spiral CT guidance, 125I seeds were implanted into the target region of tumor and in its vicinity （0.5 era）, and the particle interval was 0.5 - 1 cm. The particle radioactivity was 0.60 - 0.80 mCi （2.22× 107 - 2.96 × 107 Bq）. CT scanning （2 mm slice） was performed immediately after the implantation. The images were transferred to the computer of TPS for quality verification. Six cases had cervical lymph node metastases, and the same procedure of 125I radioactive seed implantation was employed. The short- term efficacy was evaluated at two months after the treatment, and follow- up examination was conducted once every three months. The intraoperative and postoperative adverse events were recorded. Results After treatment the ulcerative lesions disappeared or shrank in different degrees and the pain gradually relieved. At six months after the treatment, the short-term efficacy of the primary lesion was as follows： CR 50.0% and PR 38.9% with an effective rate of 88.9%. For cervical lymph node metastases, CR was 70.0% and PR was 20.0%, the effective rate was 90.0%. The adverse reactions included bleeding during operation and postoperative pain. Neither radiation injury nor particle migration occurred. The patients were followed up for 9 - 24 months, the one-year and two-year cumulative smvival rates were 94.4% and 72.2% respectively, with a median survival time of 18 months. Conclusion For the treatment of oral cancer, brachytherapy with 125I seed implantation is safe and effective with fewer complications practice.
出处
《介入放射学杂志》
CSCD
北大核心
2013年第10期851-853,共3页
Journal of Interventional Radiology
