CT引导下^(125)I粒子植入治疗鼻咽癌放疗后颈部淋巴结转移  

CT guided ^(125)I seeds implantation in treating recurrence orresidue of cervical lymphnode metastasis in patients with nasopharyngeal carcinoma after radiotherapy

作　　者：杨永锋[1] 翟福山[1] 刘明[1] 

机构地区：[1]河北医科大学第三医院放疗科,石家庄市050051

出　　处：《河北医药》2008年第11期1668-1669,共2页Hebei Medical Journal

摘　　要：目的介绍CT引导下125I粒子永久植入治疗鼻咽癌放疗后颈部淋巴结转移的的技术方法并评价其临床价值。方法16例鼻咽癌根治性放疗后颈部转移淋巴结行CT引导下125I粒子植入,依据植入前1周内CT图像应用计算机治疗计划系统制定粒子植入计划,按计划在CT引导下穿刺植入125I粒子,术后4～6个月内复查CT观察粒子分布、不良反应及疗效。结果16例共植入粒子128粒。根据疗效评价标准判定,完全缓解(CR)31.25%(5/16);部分缓解(PR)43.75%(7/16);无恶化(AC)18.75%(3/16);恶化(PD)6.25%(1/16)。总有效率(CR+PR)为75.00%(12/16),未见急性并发症和治疗相关的放射损伤。结论CT引导下125I粒子永久植入治疗鼻咽癌放疗后颈部转移淋巴结是一种安全、可靠,疗效显著的治疗方法。Objective To introduce the procedures and evaluate the clinical value of CT guided percutaneous interstitial implantation of 125 I in the treatment of recurrence or residue of cervical lymphnode metastasis in patients with nasopharyngeal carcinoma after radiotherapy.Methods CT guided interstitial ^125 I implantation was performed in 16 cases（including 12 males and 4 females,aged from 18 to 65 years） of nasopharyngeal carcinoma with recurrence or residue of cervical lymphnode metastasis following radiotherapy.Based on the CT imaging within one week before the implantation of the seeds,a computer based treatment planning system was set up,and the seeds implantation was carried out.CT scans were performed in all cases to assess seeds distribution,complication,and curative effect four to six months following seeds implantation.Results Total 128 seeds were implanted in 16 patients.In all 16 cases,CR,PR,AC and PD were 31.25%（5/16）,43.75%（7/16）,18.75%（3/16） and 6.25%（1/16）,respectively.Total effective rate（CR＋PR） was 75.00%（12/16）.No acute complications and late toxicity related to the implantation were observed.Conclusion CT guided interstitial ^125 I seeds implantation is a safe,reliable,and effective curative method for the treatment of recurrence or residue cervical lymphnode metastasis in patients with nasopharyngeal carcinoma after radiotherapy.

关 键 词：^125I粒子 组织间永久植入 鼻咽癌 淋巴结 

分 类 号：R737.250.5[医药卫生—肿瘤] R739.8[医药卫生—临床医学]