CAJ | 학술논문

目的探讨125I粒子植入治疗头颈部肿瘤单纯放疗后淋巴结复发及颈清扫+放疗后淋巴结复发患者疗效.方法 2002年9月至2009年7月收治的36例患者入组,其中单纯颈部放疗后淋巴结复发17例,颈清扫+放疗后淋巴结复发19例.局部麻醉超声或CT引导下植入3～78个粒子.粒子针间距1 cm,后退式植入粒子间距为1 cm,距影像学边界外0.5 cm.术后剂量验证实际D90为90～160 Gy,中位数130Gy.结果随访率为100%,随访满1、2年者分别为11、3例.总反应率为81%,1、2年局部控制率分别为69%、35%,生存率分别为50%、22%;颈清扫+放疗后复发组的1、2年局部控制率分别为72%、54%,单纯颈部放疗后复发组分别为67%、50%(χ2=0.00,P=0.965);生存率分别为48%、13%和51%、39%(χ2=0.17,P=0.676).结论 125I粒子植入治疗头颈部肿瘤单纯放疗后淋巴结复发及颈清扫+放疗后淋巴结复发患者是一种安全、有效的微创挽救治疗手段.
목적 탐토125I입자식입치료두경부종류단순방료후림파결복발급경청소+방료후림파결복발환자료효.방법 2002년9월지2009년7월수치적36례환자입조,기중단순경부방료후림파결복발17례,경청소+방료후림파결복발19례.국부마취초성혹CT인도하식입3～78개입자.입자침간거1 cm,후퇴식식입입자간거위1 cm,거영상학변계외0.5 cm.술후제량험증실제D90위90～160 Gy,중위수130Gy.결과 수방솔위100%,수방만1、2년자분별위11、3례.총반응솔위81%,1、2년국부공제솔분별위69%、35%,생존솔분별위50%、22%;경청소+방료후복발조적1、2년국부공제솔분별위72%、54%,단순경부방료후복발조분별위67%、50%(χ2=0.00,P=0.965);생존솔분별위48%、13%화51%、39%(χ2=0.17,P=0.676).결론 125I입자식입치료두경부종류단순방료후림파결복발급경청소+방료후림파결복발환자시일충안전、유효적미창만구치료수단.
Objective To summarize the efficacy and the feasibility of 125I seed implantation for recurrence cervical lymph node of head and neck tumor after radiotherapy or radiotherapy plus neck dissection. Methods Thirty-six patients with the recurrence cervical lymphnode of head and neck tumor after radiotherapy (17 patients) or radiotherapy plus neck dissection (19 patients) were treated with 125I seed implantation guided by ultrasound or CT under local anesthesia. The median number of seeds was 27( range from 3 to 78 ). Postoperative quality evaluation were routinely obtained for all patients. The actuarial D90 ranged from 90-160 Gy (median, 130 Gy). Results The follow-up rate was 100%. The number of the patients who were followed up over 1-and 2-year were 11 and 3. The overall response rate was 81%. The 1-and 2-year over local control rates, over survival rates were 69% and 35%, 50% and 22%, respectively.The 1-and 2-year local control rates in patients with recurrence node after radiotherapy plus neck dissection were 72% and 54%, while those were 67% and 50% in patients with recurrence node after radiotherapy,respectively (χ2=00,P=0.965). The 1-and 2-year survival rates in two groups were 48%, 13% , and 51%, 39%, respectively (χ2=0.17, P=0.676). Conclusions 125I seed implantation is a safe,minimal invasive with low morbidity and high efficacy salvage treatment method for cervical lymph node recurrence of head and neck tumor after radiotherapy with or without neck dissection.