125I放射性粒子治疗老年口腔鳞癌患者的近期疗效观察

Short-term efficacy of 125I radioactive seeds in the treatment of oral squamous cell carcinoma in elderly patients

目的:探讨125I放射性粒子植入治疗老年口腔癌患者的可行性、近期疗效及不良反应。方法:2016年6月至2018年6月徐州市中心医院口腔科老年(> 65岁)口腔癌患者12人,肿瘤部位包括舌、口底、上颌、颊、咽旁,肿瘤直径为3~9cm,实施CT引导下125I放射性粒子植入术联合尼妥珠单抗给药。平均每例患者植入32. 5颗粒子,术后即刻、3个月、6个月复查CT,随访8个月~20个月。结果:12例患者治疗总有效率达到83. 3%。主要的不良反应包括白细胞减少、恶心、呕吐、局部出血、放射性黏膜炎等,治疗过程中无严重的放射性损伤和急性并发症的发生。结论:125I放射性粒子植入联合尼妥珠单抗治疗无法手术的晚期头颈部鳞状细胞癌微创、有效、操作简便、安全性高。

Objective:To evaluate the feasibility,short-term efficacy and clinical adverse reactions of 125I radioactive seeds implantation in the treatment of elderly patients with oral cancer.Methods:From Jun.2016 to Jun.2018,twelve oral cancer patients(>65 y)from department of stomatology,the central Hospital of Xuzhou,had the treatment of iodine 125 seeds implantation combind with nimotuzumab.The tumor sites included tongue,mouth floor,maxilla,buccal area and parapharynx,and the tumor diameter ranged from 3 to 9 cm.All patients included in the study were treated with computed tomography(CT)-guided 125I radioactive seed implantation combined with nimotuzumab.An average of 32.5 particles were implanted in each patient,and CT reexamination was conducted at 3 months and 6 months immediately after surgery,followed up for 8 months to 20 months.Results:The overall effective rate was 83.3%.The main clinical adverse reactions included leukopenia,nausea,vomiting,local hemorrhage and radiation-induced oral mucositis,etc.No serious radiationinduced damages or acute complications were.occurred during the treatment.Conclusions:The method of 125I seed implantation combined with nimotuzumab for advanced head and neck squamous cell carcinoma patients who are inoperable is effective,minimally invasive,safe and easy to operate.