外放疗联合个体化导板辅助 125I放射性粒子植入治疗晚期头颈部鳞癌

目的：探讨外放疗联合个体化导板辅助¹²⁵I放射性粒子植入治疗无法手术的头颈部鳞癌的可行性及不良反应。 方法：对17例因全身系统疾病而无法手术的头颈部鳞癌患者进行常规分割放疗联合个体化导板辅助¹²⁵I放射性粒子植入增量放疗。外放疗总照射剂量为50 Gy,放射性粒子匹配周缘剂量（matched peripheral dose, MPD）为80~120 Gy。 结果：通过肿瘤体积变化情况和临床表现评价治疗标准,17例患者治疗总有效率达到82.4%（14/17）,1例死于大出血。主要的不良反应包括：软组织坏死、局部出血及放射性黏膜炎和皮炎等,治疗过程未发生急性并发症与严重的放射性损伤。 结论：外放疗联合个体化导板辅助¹²⁵I放射性粒子植入治疗晚期头颈部鳞癌,是一种微创、有效、安全性高的治疗方案。

External beam radiation therapy combined with individual template assisted iodine 125 radioactive seed implant for head and neck squamous cell carcinoma

Objective:This study aims to investigate the feasibility and side effects of external beam radiation therapy combined with individual template assisted iodine 125 radioactive seed implant in the treatment of advanced unresectable head and neck squamous cell carcinoma (HNSCC). Methods:17 patients with histologically documented advanced HNSCC, who were unable to receive surgical treatment due to their physical condition, underwent external beam radiation therapy combined with individual template assisted iodine 125 radioactive seed implant.. All patients had conventional fractionated external radiotherapy with a total dose of 50 Gy, and the matched peripheral dose of iodine 125 seed was 80~120 Gy. Results:The outcome of the treatment was evaluated based on changes of tumor size and patients’ clinical symptoms. The overall responding rate among these patients was 82.4% (14/17) . One patient died of hemorrhage. Major side effects included soft tissue necrosis, local hemorrhage, radiation mucositis and dermatitis. No other acute complications or treatment related radiation damages were observed in the study. Conclusions:The scheme of external beam radiation therapy combined with individual template assisted iodine 125 radioactive seed implant is a relatively invasive, effective and safe regimen for advanced head and neck squamous cell carcinoma.