| 吕晓鸣,石妍,刘树铭,黄明伟,郑磊,张杰,张建国.手术联合125Ⅰ放射性粒子植入治疗下颌下腺腺源性恶性肿瘤[J].中华放射医学与防护杂志,2017,37(7):505-507,556 |
| 手术联合125Ⅰ放射性粒子植入治疗下颌下腺腺源性恶性肿瘤 |
| Surgery combined with 125Ⅰ seed implantation brachytherapy for treatment of malignant submandibular gland tumors |
| 投稿时间：2017-02-20 |
| DOI：10.3760/cma.j.issn.0254-5098.2017.07.006 |
| 中文关键词: 125Ⅰ 粒子植入 下颌下腺 恶性肿瘤 |
| 英文关键词:125Ⅰ Seed implantation Submandibular gland Malignant tumors |
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| 中文摘要: |
| 目的 对手术联合125Ⅰ放射性粒子植入治疗下颌下腺腺源性恶性肿瘤进行临床初步研究。方法 选取2005年12月至2012年12月就诊于北京大学口腔医学院的下颌下腺腺源性恶性肿瘤患者32例，所有患者均行肿物及下颌下腺切除，临床及影像学检查未见淋巴结转移，未行扩大切除术或颈部淋巴结清除术。手术后结合手术前CT检查所见、肿瘤位置、大小及手术后病理学分型确定靶区，处方剂量90~110 Gy。全麻下按治疗计划将 125Ⅰ放射性粒子植入靶区。术后定期随访，观察临床疗效及并发症，计算局部-颈部控制率和远处转移率、生存率。结果 32例患者植入 125Ⅰ放射性粒子1 394颗，人均43颗，术后验证D90和V100均满足治疗需要，周围重要器官如舌、颌骨、脊髓均在耐受剂量以内。随访15~126个月，平均随访64个月，5例局部复发，5例远处转移，4例死亡。3年和5年的局部-颈部控制率分别为93.1%和87.9%，总生存率分别为93.3%和84.5%。未发现张口受限、放射性龋齿、放射性颌骨骨髓炎等并发症。结论 下颌下腺腺源性恶性肿瘤行手术切除肿物及下颌下腺，术后联合 125Ⅰ放射性粒子植入治疗，临床疗效良好，并发症小。 |
| 英文摘要: |
| Objective To evaluate the treatment of malignant submandibular gland tumors with surgery combined with 125Ⅰ radioactive implantation. Methods Thirty-two patients with malignant submandibular gland tumors were treated with surgery combined with 125Ⅰ seed implantation from December 2005 to December 2012. All of the 32 patients with primary disease were treated by excision of the submandibular gland and neoplasm. None of the patients received wide excision or neck dissection without the evidence of the neck metastases. The planning targets was based on computerized tomography (CT) images, tumors site, extent and pathologic type.The matched peripheral dose (mPD) was 90-110 Gy. Recurrence-free survival (RFS), overall survival (OS) rates and side effects were retrospectively reviewed. Results Totally 32 patients received 1394 radioactive seeds implantation, radioactive seeds and dose distributed were well in all patients. All patients were followed for 15-126 months (mean of 64 months), with 5 recurrence, 5 distant metastases, and 4 patients who died of disease. The 3-and 5-year RFS were 93.1% and 87.9%, and OS rates were 93.3% and 84.5%, respectively. No severe complications were observed during follow-up. Conclusions The excision of the neoplasm and the submandibular gland, combined with 125Ⅰ seed implantation brachytherapy was an effective modality for the treatment of malignant submandibular gland tumors. |
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