切换至 "中华医学电子期刊资源库"

中华口腔医学研究杂志(电子版) ›› 2015, Vol. 09 ›› Issue (05) : 395 -399. doi: 10.3877/cma.j.issn.1674-1366.2015.05.008

所属专题: 文献

临床研究

125I放射性粒子植入联合TPF方案治疗无法手术的头颈部鳞癌
王兴1, 孟箭1,(), 顾倩平1, 张杰1, 辜建敏1, 韩琨1   
  1. 1. 221009 徐州,东南大学医学院附属徐州医院口腔科
  • 收稿日期:2015-06-23 出版日期:2015-10-01
  • 通信作者: 孟箭
  • 基金资助:
    江苏省"六大人才高峰" D类(2012-WS-099)

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

Xing Wang1, Jian Meng1,(), Qianping Gu1, Jie Zhang1, Jianmin Gu1, Kun Han1   

  1. 1. Department of Stomatology, Affiliated Xuzhou Hospital, College of Medicine, Southeast University, Xuzhou 221009, China
  • Received:2015-06-23 Published:2015-10-01
  • Corresponding author: Jian Meng
  • About author:
    Corresponding author: Meng Jian, Email:
引用本文:

王兴, 孟箭, 顾倩平, 张杰, 辜建敏, 韩琨. 125I放射性粒子植入联合TPF方案治疗无法手术的头颈部鳞癌[J]. 中华口腔医学研究杂志(电子版), 2015, 09(05): 395-399.

Xing Wang, Jian Meng, Qianping Gu, Jie Zhang, Jianmin Gu, Kun Han. Clinical effect of iodine 125 seeds implantation synchronized chemotherapy with docetaxel, cisplatin, 5-fluorouracil for unresectable head and neck squamous cell carcinoma[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2015, 09(05): 395-399.

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.

表1 23例头颈部鳞癌患者的临床基线资料[例(%)]
图1 23例HNSCC患者总生存曲线
图2 23例HNSCC患者无进展生存曲线
表2 23例不同原发灶HNSCC患者分别采用125I放射性粒子植入联合TPF方案同期放化疗疗效评价(例)
[1]
Al-Swiahb JN,Chen CH,Chuang HC,et al. Clinical,pathological and molecular determinants in squamous cell carcinoma of the oral cavity[J]. Future Oncol,2010,6(5):837-850.
[2]
Agarwal JP,Nemade B,Murthy V,et al. Hypofractionated,palliative radiotherapy for advanced head and neck cancer[J]. Radiother Oncol,2008,89(1):51-56.
[3]
Das S,Thomas S,Pal SK,et al. Hypofractionated palliative radiotherapy in locally advanced inoperable head and neck cancer:CMC Vellore experience[J]. Indian J Palliat Care,2013,19(2):93-98.
[4]
Mohanti BK,Umapathy H,Bahadur S,et al. Short course palliative radiotherapy of 20 Gy in 5 fractions for advanced and incurable head and neck cancer:AIIMS study[J]. Radiother Oncol,2004,71(3):275-280.
[5]
Calais G,Alfonsi M,Bardet E,et al. Randomized trial of radiation therapy versus concomitant chemotherapy and radiation therapy for advanced-stage oropharynx carcinoma[J]. J Natl Cancer Inst,1999,91(24):2081-2086.
[6]
Meng J,Meng QF,Gu QP,et al. Radioactive seed implantation combined with prosthesis denture in treatment of oral and maxillofacial malignancy[J]. Cell Biochem Biophys,2013,67(3):1529-1532.
[7]
王兴,孟箭. 125I植入联合尼妥珠单抗治疗头颈部恶性肿瘤的近期疗效及安全性评价[J/CD]. 中华临床医师杂志:电子版,2013,7(13):6152-6154.
[8]
Gomez-Roca C,Koscielny S,Ribrag V,et al. Tumour growth rates and RECIST criteria in early drug development[J]. Eur J Cancer,2011,47(17):2512-2516.
[9]
Denis F,Garaud P,Bardet E,et al. Late toxicity results of the GORTEC 94-01 randomized trial comparing radiotherapy with concomitant radiochemotherapy for advanced-stage oropharynx carcinoma:comparison of LENT/SOMA,RTOG/EORTC,and NCI-CTC scoring systems[J]. Int J Radiat Oncol Biol Phys,2003,55(1):93-98.
[10]
Ahn JS,Cho SH,Kim OK,et al. The efficacy of an induction chemotherapy combination with docetaxel,cisplatin,and 5-FU followed by concurrent chemoradiotherapy in advanced head and neck cancer[J]. Cancer Res Treat,2007,39(3):93-98.
[11]
Semrau S,Schmidt D,Lell M,et al. Results of chemoselection with short induction chemotherapy followed by chemoradiationor surgery in the treatment of functionally inoperable carcinomas of the pharynx and larynx[J]. Oral Oncol,2013,49(5):454-460.
[12]
Lyman GH,Dale DC,Crawford J. Incidence and predictors of low dose-intensity in adjuvant breast cancer chemotherapy:a nationwide study of community practices[J]. J Clin Oncol,2003,21(24):4524-4531.
[13]
Jiang YL,Meng N,Wang JJ,et al. Percutaneous computed tomography/ultrasonography-guided permanent iodine-125 implantation as salvage therapy for recurrent squamous cell cancers of head and neck[J]. Cancer Biol Ther,2010,9(12):959-966.
[14]
Ruge MI,Simon T,Suchorska B,et al. Stereotactic brachytherapy with iodine-125 seeds for the treatment of inoperable low-grade gliomas in children:long-term outcome[J]. J Clin Oncol,2011,29(31):4151-4159.
[15]
Ruge MI,Kickingereder P,Grau S,et al. Stereotactic iodine-125 brachytherapy for the treatment of WHO grades Ⅱ and Ⅲ gliomaslocated in the central sulcus region[J]. Neuro Oncol,2013,15(12):1721-1731.
[16]
王兴,孟箭. 125I粒子植入治疗高龄非霍奇金淋巴瘤并吞咽困难一例[J]. 中华全科医师杂志,2015,14(5):388-389.
[17]
Khalilur R,Hayashi K,Shibuya H. Brachytherapy for tongue cancer in the very elderly is an alternative to external beamradiation[J]. Br J Radiol,2011,84(1004):747-749.
[18]
Zhang L,Chen LH,Wang J,et al. CT-guided radioactive 125I seed implantation treatment of multiple pulmonary metastases of hepatocellular carcinoma[J]. Clin Radiol,2014,69(6):624-629.
[19]
Jiang YL,Meng N,Wang JJ,et al. CT-guided iodine-125 seed permanent implantation for recurrent head and neck cancers[J]. Radiat Oncol,2010(5):68.
[20]
Zheng L,Zhang J,Zhang J,et al. Preliminary results of 125I interstitial brachytherapy for locally recurrent parotidgland cancer in previously irradiated patients[J]. Head Neck,2012,34(10):1445-1449.
[1] 陈滔, 罗洪, 周进军. 老年食管癌单纯放疗及同期放化疗患者急性不良反应影响因素分析[J]. 中华普外科手术学杂志(电子版), 2023, 17(04): 405-407.
[2] 彭莉, 张焱, 谢方红. 鼻咽癌患者外周血循环内皮细胞的检测及临床意义分析[J]. 中华细胞与干细胞杂志(电子版), 2019, 09(05): 257-261.
[3] 王兴, 孟庆飞, 邵翠玲, 白玉婷, 孟箭. 赝复体辅助术后近距离放射治疗对颌骨恶性肿瘤的作用[J]. 中华临床医师杂志(电子版), 2018, 12(10): 563-566.
[4] 李刚, 王全义, 苏金旺, 丁洁, 高鹏, 陈学波. 新型125I双链胆道引流管治疗胆管癌合并黄疸的近期疗效(附9例报告)[J]. 中华介入放射学电子杂志, 2021, 09(04): 403-406.
[5] 张宏涛, 刘晓丽, 周汝明, 于慧敏, 隋爱霞, 边艳珠, 王娟, 时高峰. SPECT/CT评价前列腺癌粒子植入剂量分布与疗效初探[J]. 中华介入放射学电子杂志, 2019, 07(04): 278-282.
[6] 陈建建, 姚远, 周学良, 焦德超, 韩新巍. 金属支架联合腔道内抗肿瘤技术治疗恶性胆道梗阻的研究现状及进展[J]. 中华介入放射学电子杂志, 2019, 07(02): 163-167.
[7] 焦德超, 钟智辉, 牛荣仿, 韩新巍, 马波, 任建庄, 孙占国, 刘娟芳, 石谨. 3D-TPS计算125I放射性粒子链径向剂量分布的实验研究[J]. 中华介入放射学电子杂志, 2018, 06(02): 154-157.
[8] 王兴, 孟箭, 顾倩平, 张杰. PET-CT在晚期上颌骨恶性肿瘤放射性粒子植入治疗中的应用价值研究[J]. 中华介入放射学电子杂志, 2016, 04(03): 142-145.
[9] 王兴, 孟箭, 李志萍, 庄乾伟, 葛良玉. 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[J]. 中华介入放射学电子杂志, 2016, 04(03): 132-135.
[10] 吕金爽, 关志宇, 郑广钧, 石树远, 朱晓雷. 靶区勾画对125I放射性粒子植入治疗非小细胞肺癌效果的影响[J]. 中华胸部外科电子杂志, 2017, 04(01): 43-48.
阅读次数
全文


摘要