^(125)I放射性粒子植入联合TPF方案治疗无法手术的头颈部鳞癌  

Clinical effect of iodine 125 seeds implantation synchronized chemotherapy with docetaxel,cisplatin,5-fluorouracil for unresectable head and neck squamous cell carcinoma

作　　者：王兴[1] 孟箭[1] 顾倩平[1] 张杰[1] 辜建敏 韩琨[1] 

机构地区：[1]东南大学医学院附属徐州医院口腔科,徐州221009

出　　处：《中华口腔医学研究杂志（电子版）》2015年第5期36-39,共4页Chinese Journal of Stomatological Research(Electronic Edition)

基　　金：江苏省"六大人才高峰"D类(2012-WS-099)

摘　　要：目的探讨125I放射性粒子植入联合多西他赛-顺铂-氟尿嘧啶(TPF)方案同期放化疗治疗无法手术的头颈部鳞癌(HNSCC)的可行性及不良反应。方法对23例初治疗的无法手术的HNSCC患者进行125I放射性粒子植入治疗,同期给予多西他赛(75 mg/m2,第1天)、顺铂(75 mg/m2,第1天)和5-氟尿嘧啶(750 mg/m2,第2~5天)化疗方案治疗3个周期。结果通过肿瘤体积变化情况和临床表现评价治疗标准,23例患者治疗总有效率达到78.3%。2年无进展生存率和总生存率分别为60.9%和52.2%,2例(8.7%)死于肿瘤复发,2例(8.7%)死于心血管疾病。主要的不良反应包括白细胞减少、恶心、呕吐、局部出血及放射性黏膜炎等,治疗过程未发生急性并发症与严重的放射性损伤。结论125I放射性粒子植入联合TPF治疗无法手术的中晚期HNSCC,是一种微创、有效、安全性高的治疗方案。Objective To discuss the feasibility and safety of radioactive Iodine 125 seeds implantation synchronized chemotherapy with docetaxel,cisplatin,5？fluorouracil （TPF） on advanced unresectable head and neck squamous cell carcinoma（HNSCC）. Methods Previously untreated patients with histologically documented advanced unresectable HNSCC underwent percutaneous radioative iodine 125 seeds interstitial implantation,and simultaneously received three cycles of chemotherapy every 21 days at a dose of 75 mg/m2 docetaxel D1,75 mg/m2 cisplatin D1,750 mg/m2 5？fluorouracil D2~5. Results The effectiveness of treament was evaluated based on tumor size and clinical symptoms in patients. The overall responding was 78.3%. A progression？free survival of 60.9%and overall survival of 52.2% was achieved at 2 years. Four each died of cardiovascular and local recurrence. Major toxicities included leucopenia, alopecia, nausea/vomiting, local hemorrhage, thrombocytopenia. No acute complications and treatment related raidation damages occurred in the trail. Conclusion The scheme of brachytherapy based on iodine 125 seeds implantation synchronized chemotherapy is a mild invasive, effective and safety regimen of advanced head and neck squamous cell carcinoma.

关 键 词：头颈部鳞癌 近距离放疗 同期放化疗 125^I放射性粒子植入 治疗计划系统 

分 类 号：R739.91[医药卫生—肿瘤]