超声引导下^(125)I放射性粒子植入治疗口腔颌面部恶性肿瘤45例分析

Analysis of oral and maxillofacial malignant tumors implanted with ^(125)I radioactive seeds under guidance of ultrasound

目的探讨超声引导下植入125I粒子治疗口腔颌面部恶性肿瘤的疗效及可行性。方法回顾性分析45例声引导下植入125I粒子治疗口腔颌面部恶性肿瘤患者的临床资料。45例患者共47个病灶,经影像学检查确定瘤体大小,超声制作计划切面,经计算机粒子治疗计划系统软件确定植入125I粒子的数量及粒子分布范围,在超声引导下经皮将125I放射性粒子植入预定部位,术后CT检查粒子分布情况及有无漏植。定期超声及CT复查,按照WHO标准评估疗效。结果 45例患者47个病灶治疗的总有效率为70.2%(包括完全缓解、部分缓解)。淋巴结转移癌治疗效果最好,其次为腮腺肿瘤。所有病例在穿刺植入过程中均无严重并发症;2例术后出现口腔溃疡。结论 125I放射性粒子植入治疗口腔颌面部恶性肿瘤疗效确切、安全,值得推广应用;在可探及的前提下,超声为首选引导方式。

Objective To retrospectively analyze 45 cases of oral and maxillofacial malignant tumors and to assess the efficacy and feasibility of oral and maxillofacial malignant tumors implanted with 125I radioactive seeds under guidance of ultrasound. Methods A total of 47 focuses in these 45 patients were determined with the size of these tumors by imaging study,the section was planed by ultrasound,the number and distribution of radioactive seeds were determined with the help of the particle treatment planning system,and were percutaneously implanted particles under guidance of ultrasound. The number and the distribution of particles were assessed by CT. Efficacy endpoints were reexamined and evaluated regularly by ultrasonic and CT according to the standards of WHO. Results The total percentage of efficacy was 70.2% （including complete remission,partial remission）. The treatment effect of metastatic carcinoma of lymph node is superior to the parotid tumor. There was no serious complication during the period of implanting and 2 patients with oral ulcers were found after operation. Conclusion The oral and maxillofacial malignant tumor treated implanted with 125I radioactive seeds under guidance of ultrasound is very effective and safe,which is deserved to popularize. The ultrasound is the first choice as a guided method for oral and maxillofacial malignant tumors.