肿瘤保守切除联合放射性粒子植入治疗腮腺癌

目的 观察肿瘤保守性切除联合¹²⁵I放射性粒子组织间永久植入治疗早期腮腺癌的临床疗效。方法 选取2004年11月至2012年6月在北京大学口腔医院就诊的腮腺癌患者共30例，所有患者行腮腺肿瘤保守性切除，术后联合¹²⁵I放射性粒子组织间永久植入治疗。中位随访时间41个月，观察临床疗效及并发症。结果 患者的5年生存率及无瘤生存率为100%，无局部复发及远处转移。手术后暂时性面神经损伤发生率为3.33%（1/30），无永久性面瘫发生，未见放射性骨髓炎、耳聋、重度张口受限等。结论 肿瘤保守性切除联合¹²⁵I放射性粒子组织间永久植入治疗早期腮腺癌临床效果良好，可保存面形，保留面神经，降低并发症发生率，提高患者生存质量。

Conservative parotidectomy combined with brachytherapy for parotid gland carcinoma

Objective To assess the efficacy of conservative parotidectomy combined with ¹²⁵I seed implant brachytherapy for patients with early parotid gland carcinomas. Methods Thirty patients with malignant parotid gland tumors underwent conservative parotidectomy while preserving facial nerve from November 2004 to June 2012. No patient underwent neck dissection simultaneously with the primary lesion. The treatment planning system was utilized for brachytherapy design, and followed by ¹²⁵I seed implantation into the target area postoperatively. The patients were followed up from 16 to 106 months, with a median duration of 41 months. The tumor recurrence was observed, while facial nerve function and radiation therapy toxicity were recorded.Results Both the 5-year survival rate and the disease-free survival rate were 100%. There was no loco-regional recurrence and metastasis. Temporary postoperative facial nerve dysfunction occurred in one patient (1/30), no permanent facial injury was observed. Severe radiation toxicity was rare. Conclusions Conservative parotidectomy combined with ¹²⁵I seed implant brachytherapy may be acceptable for early malignant parotid gland tumors, with preservation of the facial nerve, diminishing deformation and rare severe radiation toxicity.