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目的介绍CT引导下125Ⅰ粒子永久植入治疗鼻咽癌放疗后颈部淋巴结转移的技术方法并评价其临床价值。方法 16例鼻咽癌根治性放疗后颈部转移淋巴结行CT引导下125Ⅰ粒子植入,依据植入前1周内CT图像应用计算机治疗计划系统制定粒子植入计划,按计划在CT引导下穿刺植入125Ⅰ粒子,术后4～6个月内复查CT观察粒子分布、不良反应及疗效。结果 16例共植入粒子128粒。根据疗效评价标准判定,完全缓解(CR)31.25%(5/16);部分缓解(PR)43.75%(7/16);无恶化(AC)18.75%(3/16);恶化(PD)6.25%(1/16)。总有效率(CR+PR)为75.00%(12/16),未见急性并发症和治疗相关的放射损伤。结论 CT引导下125Ⅰ粒子永久植入治疗鼻咽癌放疗后颈部转移淋巴结是一种安全、可靠,疗效显著的治疗方法。
Objective To introduce the CT-guided permanent implantation of 125 I in the treatment of nasopharyngeal carcinoma after cervical lymph node metastasis of the technical methods and evaluate its clinical value. Methods Twenty-six patients with nasopharyngeal carcinoma after radical radiotherapy were treated with CT-guided 125 Ⅰ seed implantation. According to CT images, computerized planning system was used to make particle implantation plan within one week before implantation. Implantation 125I particles, 4 to 6 months after the review CT observation of particle distribution, adverse reactions and efficacy. Results 16 cases were implanted with 128 particles. 31.25% (5/16) of complete remission (CR), 43.75% (7/16) of partial remission (PR), 18.75% (3/16) of non-worsening (AC) and 6.25 % (1/16). The total effective rate (CR + PR) was 75.00% (12/16), no acute complications and treatment-related radiation damage. CONCLUSION: CT-guided permanent implantation of 125I particles in cervical metastatic lymph nodes after radiotherapy is a safe, reliable and effective therapeutic method.