CT引导下植入^(125)Ⅰ放射粒子治疗鼻窦复发性恶性肿瘤  

Treatment of recurrent malignant tumor in paranasal sinuses with radioactive particle ^(125)Ⅰ implantation by CT guidance

作　　者：王歧峰[1] 左太阳[2] 胡效坤[3] 

机构地区：[1]山东省平阴县人民医院放射科,山东济南250400 [2]山东大学齐鲁医院平邑分院,山东临沂273300 [3]青岛大学附属医院介入医学中心,山东青岛266011

出　　处：《医学影像学杂志》2014年第8期1285-1288,共4页Journal of Medical Imaging

摘　　要：目的探讨CT引导下植入125Ⅰ放射粒子治疗鼻窦复发性恶性肿瘤的方法、疗效、安全性。方法 11例鼻窦复发性恶性肿瘤患者,行CT引导下经皮穿刺植入125Ⅰ放射粒子。术前应用放射粒子近距离治疗计划系统,计划125Ⅰ放射粒子的活度和用量,粒子活度为0.6～0.8mCi,术后立即行CT扫描并进行质量验证,定期CT随访,判定分析疗效。结果11例鼻窦复发性恶性肿瘤患者,均按计划完成治疗,分别于术后2、4、6、12月复查CT,肿瘤局部控制有效率(RR)依次是:100%(11/11)、100%(11/11)、90.9%(10/11)、81.8%(9/11);3例在植入部位骨破坏区出现了明显的骨化,占27.3%(3/11),6月后行再次植入补充治疗1例,治疗后1月出现皮肤色素沉着6例,未发生皮肤溃疡。结论 CT引导下植入125Ⅰ放射粒子治疗鼻窦复发性恶性肿瘤,疗效可靠、并发症轻,值得进一步应用研究。Objective To investigate the method, efficacy and safety of radioactive particle ^125I implantation by CT guidance in treatment of recurrent malignant tumor in paranasal sinuses. Methods 11 cases of recurrent malignant tumor in paranasal sinuses were subjected to percutaneous implantation of radioactive particle ^125I under the CT guidance. Preoperatively, the lesion contour and size were ovbserved by use of radioactive seed brachytherapy treatment planning system （brachy interstitial-therapy planning system, BI-TPSTM）. The radioactivity and dosage of particle ^125I were calculated. The prescription dose （prescribed dose, PD） was 110~140 Gy and particle activity was 0.6~0.8 mCi. Postoperatively, CT scan was immediately performed and the quality was validated. The regular CT cllow-up was conducted to determine curative effect. Results 11 patients with maxillofaeial recurrent malignant tumors were completely accepted the treatment planning and underwent CT re-examination at 2 months, 4 months, 6 months, and 12 months after operation, respectively. The local tumor control rate （RR） was 100%（11/11）, 100%（11/11）, 90.9%（10/11）, 81.8%（9/11） in order of the indicated time points. 3 cases appeared obvious ossification in destroyed bone area at the implanted site, accounting for 27.3 % （3/11）. One patient was implanted once more 6 months later. 6 patients appeared skin pigmentation one month after the treatment. Conclusion Radioactive particle ^125I implantation guided by CT is simple, reliable curative effect, high safety in treatment of recurrent malignant tumor in paranasal sinus. It is worthy for further application research.

关 键 词：放射学 介入性 ^125Ⅰ放射粒子 近距离放射治疗 鼻窦复发性恶性肿瘤 

分 类 号：R739.6[医药卫生—肿瘤] R814.42[医药卫生—临床医学]