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个体化模板引导125I粒子植入治疗头颈部晚期无法手术切除的腺源性恶性肿瘤

Therapeutic effect of individualized template-guided 125I seed implants for unresectable malignant salivary gland tumors

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【作者】 郑浩杨旭东孟箭

【Author】 ZHENG Hao;YANG Xu-dong;Meng Jian;Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital;Department of Stomatology, The Affiliated Xuzhou Hospital of Medical College of Southeast University;

【机构】 南京大学医学院附属口腔医院口腔颌面外科东南大学医学院附属徐州医院口腔科

【摘要】 目的 :观察个体化模板引导125I粒子组织间植入治疗头颈部晚期无法手术腺源性恶性肿瘤的近期效果,探讨个体化模板在晚期肿瘤治疗中的安全性及优越性。方法:对14例无法手术的颌面部晚期腺源性恶性肿瘤患者进行个体化模板制作,并引导125I粒子植入治疗。术后定期随访,统计粒子分布情况、疾病有效率、局部控制率、总生存率以及副反应。结果:14例患者粒子平均植入数为43颗,平均D90为186.2 Gy,平均V100为98.2%,平均V150为43.3%,眼球放射量平均3.2 Gy,脑放射剂量平均32.5 Gy;14例患者总有效率为85.7%。术后随访1528个月,平均23个月;2年局部控制率为78.6%;全部患者总生存率为78.6%,1年生存率为85.7%;未出现3级及以上放射性损伤。结论:对于头颈部晚期无法手术切除的腺源性恶性肿瘤,个体化模板引导125I粒子植入治疗安全、有效,操作简便,可控性好,值得临床推广应用。

【Abstract】 PURPOSE: To evaluate the short-term effect of individualized template guided125I seed implants for advanced unresectable malignant salivary gland tumors, and explore its superiority. METHODS: Fourteen patients with histologically documented advanced unresectable malignant salivary gland tumors were treated by radioactive125I seeds interstitial implantation under the aid of individualized template guide. The treatment response, distribution of seeds, local control rate and survival rate were evaluated and the adverse events observed. RUSULTS: The actuarial median number of125I seeds treated was 43, and actuarial median D90,V100,V150 was 186.2 Gy, 98.2%, 43.4%, respectively; The average radiation dose received by the eyes and brain was 3.2 Gy, 32.5 Gy, respectively; The overall response rate was 78.3%. The patients were followed up for 15 to 28 months(median 23 months). The local control rate was 78.6%, and overall survival rate was 78.6%. No serious side radiotherapeutic effect was observed. CONCLUSIONS: The method of individualized template-guided125I seed implants for advanced unresectable malignant salivary gland tumors is feasible, minimally invasive, safe and easy to operate, which can be widely used in clinical practice.

【基金】 徐州社会发展科技基金资助项目(XM12B037);江苏省“六大人才高峰”资助项目(2012-WS-099);徐州市创新团队课题资助项目(XWCX201604)
  • 【文献出处】 中国口腔颌面外科杂志 ,China Journal of Oral and Maxillofacial Surgery , 编辑部邮箱 ,2017年02期
  • 【分类号】R739.91
  • 【下载频次】74
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