CAJ | 학술논문

目的探讨125Ⅰ植入治疗复发/转移头颈部恶性肿瘤的可行性和近中期临床疗效.方法 2003年1月-2008年5月,头颈部癌术后或放化疗后复发或转移35例,男23例、女12例,年龄39～71岁,中位年龄为56岁,在局部浸润麻醉下,CT、B超或腔内镜引导125Ⅰ粒子植入术,可评价病灶42个,病灶最大径2.0～9.0 cm,平均值4.2 cm.每个病灶植入粒子数目为12～70粒,中位粒子数33粒,粒子活度为29.6 MBq,粒子间距0.5～1.0 cm,肿瘤周边匹配剂量(MPD)为90～160 Gy,随访观察局部控制率,总体生存率,疼痛缓解情况及并发症.结果随访4～40个月,4个月后评价42个局部病灶评价CR 24/42,PR 11/32,SD 5/42,PD 2/42,临床有效率83.3%(CR+PR);总体1年生存率88.4%,2年生存率72.4%,3年生存率45.2%,中位生存时间31个月;疼痛缓解率17/23(73.4%).近期副反应轻微,远期副反应主要表现为植入粒子侧皮肤色素沉着4例,3例面颊部长期麻木感,口腔干涩2例,长期头痛伴感染1例,未见大出血、急性肺栓塞、局部脓肿、窦道、脑脊液漏等严重并发症.结论 CT导向下放射性粒子植入头颈部复发和转移恶性肿瘤,并发症发生率低,患者生活质量改善明显,临床疗效确切,是一种简单、安全、有效的方法.
목적 탐토125Ⅰ식입치료복발/전이두경부악성종류적가행성화근중기림상료효.방법 2003년1월-2008년5월,두경부암술후혹방화료후복발혹전이35례,남23례、녀12례,년령39～71세,중위년령위56세,재국부침윤마취하,CT、B초혹강내경인도125Ⅰ입자식입술,가평개병조42개,병조최대경2.0～9.0 cm,평균치4.2 cm.매개병조식입입자수목위12～70립,중위입자수33립,입자활도위29.6 MBq,입자간거0.5～1.0 cm,종류주변필배제량(MPD)위90～160 Gy,수방관찰국부공제솔,총체생존솔,동통완해정황급병발증.결과 수방4～40개월,4개월후평개42개국부병조평개CR 24/42,PR 11/32,SD 5/42,PD 2/42,림상유효솔83.3%(CR+PR);총체1년생존솔88.4%,2년생존솔72.4%,3년생존솔45.2%,중위생존시간31개월;동통완해솔17/23(73.4%).근기부반응경미,원기부반응주요표현위식입입자측피부색소침착4례,3례면협부장기마목감,구강간삽2례,장기두통반감염1례,미견대출혈、급성폐전새、국부농종、두도、뇌척액루등엄중병발증.결론 CT도향하방사성입자식입두경부복발화전이악성종류,병발증발생솔저,환자생활질량개선명현,림상료효학절,시일충간단、안전、유효적방법.
Objective to evaluate the short- and medium-term clinical effects of 125Ⅰ seed implantation on recurrent or metastatic head and neck cancers. Methods Thirty patients with recurrent or metastatic head and neck cancers after operation, radiotherapy, or chemotherapy, totaling 421 lesions 4.2 (2-9) cm in diameter, 23 males and 12 females, aged 56 (39-71) , underwent implantation of 12 -70 125Ⅰ seeds (on average 33 per person) under the guidance of CT, uhrasonography, or endoscopy with an interval of 1 cm between any 2 seeds with the radioactive activity per seed of 29.6 MBq and matchedperipheral dose Of 90-160 Gy. Follow-up was conducted for 13 (4-40) months to observe the local control rate, overall survival rate, pain relief, and clinical complications. Results Follow-up 4 months later showed that 24 of the 42 lesions obtained complete remission, 11 obtained partial remission, 5 no change, and 2 progress of disease, with a clinical response rate of 83.3% (CR + PR). The overall 1-, 2-, and 3-year survival rates were 88.4%, 72.4%, and 45.2% respectively with a median survival time of 31 months. The pain relief rate was 73.4% (17/23). The long-term complications included hyperpigmentation at operative sites (n=4), insensible feeling on lateral cheek (n=3), dryness of oral cavity ( n = 2), andheadache combined with infection (n=1). Conclusion Relieving the pain, improving the life quality, CT guided radioactive 125Ⅰ seed implantation is a simple, safe, and effective method in treating recurrent or metastatic head and neck cancer with minimal damage and few complications.