^(125)I粒子植入治疗颈部淋巴结转移癌疗效分析及引起臂丛神经损伤临床探讨

Clinical study of ^(125)I seed implantation for treatment of cervical lymph node metastasis and injury of brachial plexus

目的初步探讨^(125)I粒子植入治疗颈部淋巴结转移癌的疗效及对患侧臂丛神经损伤的影响。方法回顾性分析接受^(125)I粒子植入治疗的22例颈部淋巴结转移癌患者共26个病灶。评价患者临床受益反应、2个月局部控制率、1年生存率及并发症情况。结果随访时间2~21个月,中位时间11个月,临床受益率72.7%,有效率61.5%,2个月局部控制率84.6%,1年生存率36.4%。其中4例患者出现臂丛神经受损。结论 CT引导下^(125)I粒子植入低剂量长时间持续内照射治疗颈部淋巴结转移癌的近期疗效较好,创伤小;但引起臂丛神经损伤是不可治愈的并发症之一,造成患者残疾,严重影响患者的生活质量。

Objective To evaluate the clinical efficacy of ^125I seedimplantation in treating cervical lymph node metastasis and the impact on brachial plexus injuries. Methods Retrospectively analyzed the 26 focus of 22 cervical lymph node metastasis patients after the cure of ^125I seed. To evaluate patientg clinical benefit response, two - month local tumor con- trol rate, one - year survival rate, and the complications were recorded. Results All the patients were followed up for 2 ~ 21 months with a median time of 11 months. The clinical benefit rate, overall effective rate and two - month local tumor control rate were 72. 7% ,61.5% ,and 84. 6% respectively,the one - year survival rate was 36.4%. Four of these pa- tients had a braehial plexus injury. Conclusion For the treatment of cervical lymph node metastasis with low dose and prolonged continuous internal, CT - guided radioactive ^125I seed implantation has a better short - term effect and less complication. But the brachial plexus injury is one of the incurable complications,it can result in patients disability, and affect the patients＇ quality of life.