CAJ | 학술논문

目的研究125I粒子腮腺区组织间近距离治疗对面神经功能恢复的影响.方法对无面瘫的21例腮腺原发癌患者,采用外科手术切除(保存面神经),术后1周行125I放射性粒子腮腺区组织间治疗,粒子活度24.05×106～25.9×106 Bq,处方剂量60 Gy.应用House-Brackmann(HB)评价系统和面神经肌电图对患者分别进行主观评价和客观评价,随访时间4年.按照面神经功能分区评价的方法,以神经传导潜伏时为指标,将患侧面神经分为异常组和正常组,分别与健侧相应面神经分支进行比较.结果所有患者术后均出现不同程度面瘫,随访术后6个月内均恢复至术前正常水平;面神经患侧异常组与健侧对应神经分支传导潜伏时的差异在术后1周至术后6个月具有统计学意义(t=2.362,P=0.028),患侧较健侧明显延长,而术后1～4年差异无统计学意义;面神经患侧正常组与健侧对应分支神经传导潜伏时的差异在术后1周具有统计学意义(t=2.522,P=0.027),患侧较健侧延长,而术后2月～4年差异无统计学意义.结论 125I粒子组织间近距离治疗不影响腮腺癌术后面神经功能的临床恢复,对面神经无迟发损害.
목적 연구125I입자시선구조직간근거리치료대면신경공능회복적영향.방법 대무면탄적21례시선원발암환자,채용외과수술절제(보존면신경),술후1주행125I방사성입자시선구조직간치료,입자활도24.05×106～25.9×106 Bq,처방제량60 Gy.응용House-Brackmann(HB)평개계통화면신경기전도대환자분별진행주관평개화객관평개,수방시간4년.안조면신경공능분구평개적방법,이신경전도잠복시위지표,장환측면신경분위이상조화정상조,분별여건측상응면신경분지진행비교.결과 소유환자술후균출현불동정도면탄,수방술후6개월내균회복지술전정상수평;면신경환측이상조여건측대응신경분지전도잠복시적차이재술후1주지술후6개월구유통계학의의(t=2.362,P=0.028),환측교건측명현연장,이술후1～4년차이무통계학의의;면신경환측정상조여건측대응분지신경전도잠복시적차이재술후1주구유통계학의의(t=2.522,P=0.027),환측교건측연장,이술후2월～4년차이무통계학의의.결론 125I입자조직간근거리치료불영향시선암술후면신경공능적림상회복,대면신경무지발손해.
Objective To study the influence of 125I seed interstitial brachytherapy in parotid region on the recovery of facial nerve function. Methods A total of the data of 21 patients with primary parotid carcinoma were treated with resection and 125I interstitial brachytherapy. All the patients had no facial palsy before operation and the prescribed dose was 60 Gy. During 4 years of follow-up, the HouseBrackmann grading scales and ENoG were used to evaluate the function of facial nerve. According to the modified regional House-Brackmann grading scales, the facial nerve branches of patients in affected side were divided into normal and abnormal groups, and were compared with those in contra-lateral side.Results Post-operation facial palsy occurred in all the patients, but the facial palsy recovered within 6 months. The latency time differences between affected side and contralateral side were statistically significant in abnormal group from 1 week to 6 months after treatment ( t = 2.362, P = 0.028 ), and were also different in normal group 1 week after treatment ( t = 2.522, P = 0.027 ). Conclusions 125I interstitial brachytherapy has no influence on recovery of facial nerve function after tumor resection and no delayed facial nerve damage.