增强CT-超声融合成像引导^(125)I粒子植入治疗局部复发性头颈部恶性肿瘤的临床疗效

Clinical effect of ^(125)I seed implantation guided by enhanced CT-ultrasound fusion imaging in the treatment of locally recurrent malignant tumor of the head and neck

目的评估增强CT-超声融合成像引导^(125)I粒子植入治疗局部复发性头颈部恶性肿瘤的临床疗效。方法将54例头颈部恶性肿瘤局部复发患者随机分为融合成像组(27例)和单一成像组(27例),分别采用增强CT-超声融合成像引导125 I粒子植入治疗和单纯超声成像引导^(125)I粒子植入治疗。比较2组患者90%靶体积所接受的剂量(D90)、靶区接受90%处方剂量的体积百分比(V90)、粒子补种率、粒子植入时间和粒子植入相关不良反应。结果融合成像组和单一成像组的D90、V90比较,差异有统计学意义(P<0.05);融合成像组的粒子补种率低于单一成像组(P<0.05);融合成像组的粒子植入时间长于单一成像组(P<0.05);术后2组患者局部皮下血肿、急性放射损伤等不良反应发生率比较,差异均无统计学意义(P>0.05)。结论增强CT-超声融合成像引导^(125)I粒子植入治疗局部复发性头颈部恶性肿瘤的剂量分布更加合理,补种率低,可有效提高粒子植入精准性。

Objective To evaluate the clinical efficacy of ^(125)I seed implantation guided by enhanced CT-ultrasound fusion imaging in the treatment of locally recurrent malignant tumor of the head and neck.Methods Fifty-four patients with locally recurrent malignant tumor of the head and neck were randomly divided into the fusion imaging group(n=27)and the single imaging group(n=27),and enhanced CT-ultrasoun d fusion imaging guided ^(125)I seed implantation and simple ultrasound imaging guided ^(125)I seed implantation were performed respectively.The dose received by 90%target volume(D90),percentage of the volume covered by 90%prescription dose in target volume(V90),seed reseeding rate,time of seed implantation and adverse reactions related to seed implantation were compared between the two groups.Result s Comparison of D90 and V90 between the fusion imaging group and the single imaging group showed statistically significant difference(P<0.05).The seed reseeding rate of the fusion imaging group was lower than that of the single imaging group(P<0.05).The time of seed implantation in the fusion imaging group was longer than that in the single imaging group(P<0.05).There was no statistically significant difference in the incidence of local subcutaneous hematoma,acute radiation injury or other adverse reactions between the two groups(P>0.05).Conclusion Enhanced CT-ultrasound fusion imaging guided ^(125)I seed implantation in the treatment of locally recurrent malignant tumor of the head and neck has more reasonable dose distribution and lower reseeding rate,and it can effectively improve the accuracy of seed implantation.