摘要
目的:初步评价外放疗联合碘-125(125I)粒子植入治疗头颈癌患者的局部控制率和放射性损伤的有关结果。方法:选择2008年2月至2010年7月在北京大学口腔医院口腔颌面外科就诊的头颈癌患者10例,其中鳞状细胞癌8例,低分化腺癌2例,均因全身疾病或局部晚期而不能手术治疗。所有患者均先接受常规分割外放疗,然后再行125I粒子植入增量放疗。外放疗总照射剂量(total dose,DT)为50 Gy(鳞癌)或70 Gy(低分化腺癌);125I粒子植入治疗的匹配周缘剂量(matched peripheral dose,MPD)为60 Gy(TNM分期为Ⅰ~Ⅱ)或80 Gy(TNM分期为Ⅲ~Ⅳ)。125I粒子活度为25.9~29.6 MBq/个。对患者进行随访,分析急性放射性损伤、晚期放射性损伤、局部控制和生存情况。结果:平均随访12个月(2~28个月),有1例出现软组织坏死,1例出现吞咽困难和局部大出血,余未见其他严重副作用。所有病灶均在6个月内完全消退,1例出现颈淋巴结转移,1例出现远处转移,余未见复发和转移。10例患者中有7例存活。结论:外放疗联合125I粒子植入是治疗不能根治手术头颈癌患者的一种安全、有效的选择方法。
Objective： To evaluate the relative incidence of local control and toxicity in patients with head and neck cancers who underwent external beam radiotherapy（EBRT） plus 125I seeds implantation.Methods： Ten patients diagnosed as head and neck cancers at the department of oral and maxillofacial surgery of Peking University School of Stomatology during the period of February 2008 to July 2010 were collected.The histologic types included squamous cell carcinoma in 8 patients,poorly differentiated adenocarcinoma of salivary gland in 2 patients.All patients could not receive surgical treatment due to poor medical status or unresectable advanced-stage tumors and underwent EBRT plus 125I seeds implantation.Eight patients with squamous cell carcinoma had conventional fractionated EBRT with a total dose of 50 Gy;two patients with poorly differentiated adenocarcinoma had conventional fractionated EBRT with a total dose of 70 Gy.They all then had 125I seeds implantation with matched peripheral dose of 60 Gy（TNM stage Ⅰ-Ⅱ） or 80 Gy（TNM stage Ⅲ-Ⅳ）.The apparent activity per seed ranged from 25.9 to 29.6 MBq.Follow-up of the patients was done to analyze acute and late toxicity,local control,and survival.Results： After a median follow-up of 12 months（range 2-28 months）,soft tissue necrosis was seen in one patient,dysphagia and hemorrhage in another.No other serious side effects were observed.All the tumor mass of 10 cases disappeared within 6 months,regional metastases was observed in one patient,and distant metastases was observed in another.Seven of 10 patients survived till the date of investigation.Conclusion： External beam radiotherapy plus 125I seeds implantation is a safe and effective therapy regimen for patients with unrectable head and neck cancers.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2011年第1期102-105,共4页
Journal of Peking University:Health Sciences
关键词
近距离治疗
外放疗
碘-125粒子
头颈癌
Brachytherapy
External beam radiotherapy
Iodine-125 seed
Head and neck cancer
