放射性（125）I粒子组织间植入治疗口腔颌面部恶性肿瘤近期疗效

Short-term efficacy of CT-guided iodine-125 interstitial implantation in oral carcinoma

目的探讨放射性125I粒子植入治疗口腔颌面部恶性肿瘤方法、近期疗效和并发症。方法选择2009年6月至2011年6月中山大学附属第一医院口腔颌面外科病房6例口腔颌面部恶性肿瘤患者,在CT引导下实施125I放射性粒子植入治疗。1～4个月复查CT,随访6～19个月。结果所有病例均顺利完成粒子植入,平均每例患者植入25.6颗粒子,5例患者粒子植入后分布情况与术前治疗计划系统结果相符,1例患者植入37颗粒子后CT扫描显示靶区粒子分布不匀,7d后补种9颗。术后TPS验证肿瘤匹配周边剂量90～140Gy。对4例舌癌低剂量区和颈部亚临床病灶补充外照射40～46Gy。手术后1～4个月复查CT,未出现粒子移位,局部控制良好,随访6～19个月,植入区未见肿瘤复发,局部控制良好。2例患者短暂出血反应,3例出现轻度咽喉部吞咽疼痛。未见远期方式损伤。结论 CT引导下125I放射性粒子植入靶区,安全可靠,创伤小,控制口腔癌病灶及颈淋巴结转移近期效果满意。

Objective To investigate the methods,short-term effect and the complications of iodine-125 interstitial implantation in treating oral cancer.Methods From Jun.2009 to Jun.2011,six oral cancer patients from department of stomatology,the First Affiliated Hospital of Sun Yat-sen University,had the treatment of CT-guided iodine-125 interstitial implantation.CT scanned to evaluate the outcomes 1～4 months later.The period of following-up survey is 6～19 months.Results The seeds were implanted successfully in 6 patients and average number of implant is 25.6.The iodine-125 seeds distributed well according to TPS in 5 cases.1 case had some defect as CT scanned after implantation,9 seeds were implanted 7 days later.TPS dose verification around tumor is 90～140 Gy.Low dosage area and inferior focus of four tongue cancer patients had external irradiation of 40～46 Gy.All patients have CT scanned after 1～4 months and were followed up for 6～19 months,no recurring was seen in the targetarea.Transient hemorrhage occurred in 2 patients and dysphagia in 3 patients.No radiation injury in long-term.Conclusion In short-term outcome,CT-guided iodine-125 implantation is effective and safety in treating oral cancer,withminimal invasive and slight complications.