目的

探讨放射性¹²⁵I 粒子植入治疗口腔颌面部恶性肿瘤方法、近期疗效和并发症。

方法

选择2009 年6 月至2011 年6 月中山大学附属第一医院口腔颌面外科病房6 例口腔颌面部恶性肿瘤患者，在CT 引导下实施¹²⁵I 放射性粒子植入治疗。 1 ～4 个月复查CT，随访6 ～19 个月。

结果

所有病例均顺利完成粒子植入，平均每例患者植入25.6 颗粒子，5 例患者粒子植入后分布情况与术前治疗计划系统结果相符，1 例患者植入37 颗粒子后CT 扫描显示靶区粒子分布不匀，7 d 后补种9 颗。 术后TPS 验证肿瘤匹配周边剂量90 ～140 Gy。对4 例舌癌低剂量区和颈部亚临床病灶补充外照射40 ～46 Gy。 手术后1 ～4 个月复查CT，未出现粒子移位，局部控制良好，随访6 ～19 个月，植入区未见肿瘤复发，局部控制良好。 2 例患者短暂出血反应，3 例出现轻度咽喉部吞咽疼痛。 未见远期方式损伤。

结论

CT 引导下¹²⁵I放射性粒子植入靶区，安全可靠，创伤小，控制口腔癌病灶及颈淋巴结转移近期效果满意。

Objective

To investigate the methods， short-term effect and the complications of iodine-125 interstitial implantation in treating oral cancer.

Methods

From Jun.2009 to Jun. 2011， six oral cancer patients from department of stomatology， the First Affiliated Hospital of Sun Yat-sen University， had the treatment of CT-guided iodine-125 interstitial implantation. CT scanned to evaluate the outcomes 1 ～4 months later. The period of following-up survey is 6 ～19 months.

Results

The seeds were implanted successfully in 6 patients and average number of implant is 25.6. The iodine-125 seeds distributed well according to TPS in 5 cases. 1 case had some defect as CT scanned after implantation， 9 seeds were implanted 7 days later. TPS dose verification around tumor is 90 ～140 Gy. Low dosage area and inferior focus of four tongue cancer patients had external irradiation of 40 ～46 Gy. All patients have CT scanned after 1 ～4 months and were followed up for 6 ～19 months， no recurring was seen in the target area. Transient hemorrhage occurred in 2 patients and dysphagia in 3 patients. No radiation injury in long-term.

Conclusion

In short-term outcome， CT-guided iodine-125 implantation is effective and safety in treating oral cancer， with minimal invasive and slight complications.