腭部恶性肿瘤近距离放疗中义齿基托布源器的设计与制作  

Denture-like applicators with radioactive seeds for treatment of palatal malignant tumors

作　　者：谭京[1] 王兵[2] 黄明伟[3] 张建国[3] 周永胜[1] 

机构地区：[1]北京大学口腔医学院.口腔医院修复科,北京100081 [2]北京大学口腔医学院.口腔医院技工中心,北京100081 [3]北京大学口腔医学院.口腔医院口腔颌面外科,北京100081

出　　处：《北京大学学报（医学版）》2011年第1期145-147,共3页Journal of Peking University:Health Sciences

摘　　要：目的：设计与制作含有125I放射性粒子的义齿基托布源器,应用其对腭部腺源性恶性肿瘤进行术后放射性粒子近距离放射治疗。方法：42例硬腭或软硬腭交界处的腺源性恶性肿瘤患者,经局部手术切除术后佩戴含有125I放射性粒子的义齿基托布源器进行近距离放疗。义齿基托布源器由3部分组成：组织面为树脂层,用于容纳放射性粒子;磨光面为钴铬合金层,用于对正常组织提供放射性防护;还有起固位作用的卡环。义齿基托布源器的固位与稳定参考可摘局部义齿的设计原则设计,如患者伴有上颌牙齿缺失,则可在布源器上排列人工牙,以同期恢复患者咀嚼功能。结果：42例患者佩戴使用义齿基托布源器良好,放射性粒子没有移位、丢失。随访12~72个月,照射区组织愈合良好,恶性肿瘤未见复发。所有患者均未观察到严重并发症。结论：放射性粒子治疗腭部恶性肿瘤时,义齿基托布源器有利于实现靶区治疗,该方法具有方便、有效,并对周围正常组织具有放射性防护的特点。Objective：To design and make denture-like applicators containing radioactive seeds for treatment of malignant tumors in the hard palate where only thin layers of soft tissues are available.Methods： Forty-two patients were treated with denture-like applicators containing 125I radioactive seeds after local resection of malignant salivary gland tumors the hard palate.Sixteen patients were male,and 26 patients were female.The average age was 37.6 years old（18-74 years old）.The denture-like applicators were consisted of three parts： resin layer（about 1.0 mm in thickness） which contacted with surgical area and contained radioactive seeds;the cobalt-chromium alloy layer（about 1.0 mm in thickness） which protected surrounding normal tissues;the clasps which acted as retainers for applicators.The resin layer and the alloy layer were connected together mechanically.Artificial teeth were applied on the applicators to restore the masticatory function when partially edentulous upper jaws were available.All these patients were followed up for 12-72 months.The complications in target areas and adjacent normal tissues were observed.The stability of radioactive seeds,the recurrence of the tumor was also observed during the follow-up.Results： No patients complained about hurt or burning of adjacent normal tissues.8/42 patients felt some uncomfortable,such as gagging,more saliva on the first one or two days.No radioactive seeds were lost and dislocated during the treatment.The surgical wounds healed perfectly.No mucosal ulcer,no recurrence of tumor,and no other complications for the target areas were observed.The living standard of the patients was improved.Conclusion： The denture-like applicator containing 125I radioactive seeds is a feasible,effective,and convenient way to treat malignant tumors around the hard palate,where there is no enough room to implant radioactive seeds.This method can effectively irradiate the target areas when treating the malignant tumors in the palate.

关 键 词：义齿基托 近距离放射疗法 碘放射性同位素 肿瘤 腭 硬 

分 类 号：R739.83[医药卫生—肿瘤]