CT引导放射性~(125)I粒子组织间植入治疗头颈部复发性肿瘤

目的探讨CT引导下放射性125I粒子组织间植入近距离治疗头颈部复发性肿瘤的可行性和近期疗效。方法 2006年12月～2009年12月,对16例头颈部复发性肿瘤行CT引导下放射性125I粒子植入术。植入术前应用三维治疗计划系统(TPS)制定粒子植入计划,术中根据CT影像采取不同进针路径,粒子间距0.5～1.0cm,粒子活度0.50～0.80mCi。术后复扫CT观察粒子分布情况,并再次应用TPS进行术后剂量验证,最小周边剂量范围为106～218Gy。结果 16例均顺利完成手术,植入粒子17～158颗(中位数44颗)。随访3～36个月,中位随访时间11.5月。局部有效率68.8%(11/16),中位局部控制时间18.0月,平均生存时间25.9月。1年局部控制率67.7%,2年33.9%,3年33.9%。1年生存率76.7%,2年57.5%,3年57.5%。结论 CT引导下放射性125I粒子组织间植入精确可控,微创,安全,近期疗效确切。

CT-guided Implantation of Interstitial 125I Seed for Brachytherapy of Recurrent Head and Neck Tumor

Objective To investigate the feasibility and short-term efficacy of CT-guided implantation of interstitial ^125I seed in the treatment of recurrent head and neck tumor.Methods Since December 2006 to December 2009,we performed CT-guided implantation of interstitial 125I seed on 16 patients with recurrent head and neck tumor.Before the implantation,TPS was employed to confirm the seed number and needle placement.Different puncture approach was carried out according to CT images.The seeds（0.50-0.80 mCi）were implanted at an interval of 0.5-1.0 cm.To observe the distribution of the seeds,postoperative CT-scan was carried out and then evaluation by TPS was made with the MPD ranged from 106-218 Gy.Results The procedure was completed in all the 16 cases with 17-158 seeds implanted（median,44）in each patient.The patients were followed up for 3 to 36 months（median,11.5 months）;during the period we noticed a local effective rate of 68.8%（11/16）,median local-controlled time of 18.0 months,and mean survival time of 25.9 months.The 1-,2-,and 3-year local-controlled rate was 67.7%,33.9%,and 33.9%,respectively.And 1-,2-,and 3-year survival rate was 76.7%,57.5%,and 57.5%.Conclusion CT-guided implantation of interstitial ^125I seed is accurately controllable,minimally invasive,safe,and effective in a short term.