外放疗联合个体化导板辅助<sup>125</sup>I放射性粒子植入治疗晚期头颈部鳞癌

doi:10.3877/cma.j.issn.2095-5782.2016.03.002

中华介入放射学电子杂志 ›› 2016, Vol. 04 ›› Issue (03) : 132 -135. doi: 10.3877/cma.j.issn.2095-5782.2016.03.002

所属专题：文献；

肿瘤介入

外放疗联合个体化导板辅助¹²⁵I放射性粒子植入治疗晚期头颈部鳞癌

王兴¹, 孟箭¹^,^†(

), 李志萍¹, 庄乾伟¹, 葛良玉¹

^1. 221009　徐州，徐州市中心医院口腔科

收稿日期:2016-05-21 出版日期:2016-08-01
通信作者: 孟箭
基金资助:
江苏省"六大人才高峰"D类项目(2012-WS-099); 徐州市医学创新（技术攻关）领军人才项目(XWCX201604)

External beam radiation therapy combined with individual template assisted iodine ¹²⁵ radioactive seed implant for head and neck squamous cell carcinoma

Xing Wang¹, Jian Meng¹^,^†(), Zhiping Li¹, Qianwei Zhuang¹, Liangyu Ge¹

^1. Department of Stomatology, Xuzhou Central Hospital , Xuzhou 221009, China

Received:2016-05-21 Published:2016-08-01
Corresponding author: Jian Meng
About author:
Corresponding author: Meng Jian, Email: mrocketj@126.com

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目的：

探讨外放疗联合个体化导板辅助¹²⁵I放射性粒子植入治疗无法手术的头颈部鳞癌的可行性及不良反应。

方法：

对17例因全身系统疾病而无法手术的头颈部鳞癌患者进行常规分割放疗联合个体化导板辅助¹²⁵I放射性粒子植入增量放疗。外放疗总照射剂量为50 Gy，放射性粒子匹配周缘剂量（matched peripheral dose, MPD）为80~120 Gy。

结果：

通过肿瘤体积变化情况和临床表现评价治疗标准，17例患者治疗总有效率达到82.4%（14/17），1例死于大出血。主要的不良反应包括：软组织坏死、局部出血及放射性黏膜炎和皮炎等，治疗过程未发生急性并发症与严重的放射性损伤。

结论：

外放疗联合个体化导板辅助¹²⁵I放射性粒子植入治疗晚期头颈部鳞癌，是一种微创、有效、安全性高的治疗方案。

关键词: 头颈部鳞癌, 近距离放疗, 外放疗, ¹²⁵I粒子植入, 个体化导板

Objective:

This study aims to investigate the feasibility and side effects of external beam radiation therapy combined with individual template assisted iodine 125 radioactive seed implant in the treatment of advanced unresectable head and neck squamous cell carcinoma (HNSCC).

Methods:

17 patients with histologically documented advanced HNSCC, who were unable to receive surgical treatment due to their physical condition, underwent external beam radiation therapy combined with individual template assisted iodine 125 radioactive seed implant.. All patients had conventional fractionated external radiotherapy with a total dose of 50 Gy, and the matched peripheral dose of iodine 125 seed was 80~120 Gy.

Results:

The outcome of the treatment was evaluated based on changes of tumor size and patients’ clinical symptoms. The overall responding rate among these patients was 82.4% (14/17) . One patient died of hemorrhage. Major side effects included soft tissue necrosis, local hemorrhage, radiation mucositis and dermatitis. No other acute complications or treatment related radiation damages were observed in the study.

Conclusions:

The scheme of external beam radiation therapy combined with individual template assisted iodine 125 radioactive seed implant is a relatively invasive, effective and safe regimen for advanced head and neck squamous cell carcinoma.

Key words: Head and neck squamous cell carcinoma, Brachytherapy, External beam radiation therapy, Iodine 125 radioactive seed implant, Individual template

图1 个体化引导模板

图2 粒子术中导板引导下插植

图3 左侧腮腺鳞癌治疗前后增强CT图像

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External beam radiation therapy combined with individual template assisted iodine ¹²⁵ radioactive seed implant for head and neck squamous cell carcinoma

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External beam radiation therapy combined with individual template assisted iodine 125 radioactive seed implant for head and neck squamous cell carcinoma

External beam radiation therapy combined with individual template assisted iodine ¹²⁵ radioactive seed implant for head and neck squamous cell carcinoma