外放疗联合碘-125粒子植入治疗头颈癌的临床应用

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。

Combined external radiotherapy and 125I-particle implantation for treatment of head and neck cancers

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 o...