-
腺样囊性癌(adenoid cystic carcinoma, ACC)是一种具有局部侵袭性、复发率高、低潜在远处转移特点的恶性肿瘤, 它好发于涎腺、泪腺、气管等部位, 头颈部是其最常发生的部位[1]。临床上常采用手术结合放疗的综合治疗方法来治疗ACC。许多学者对其手术联合外放疗、手术联合近距离治疗、手术联合外放疗及近距离治疗等疗效进行了对比研究[2-7]。本文就125I粒子植入治疗头颈部ACC的作用作一综述。
125I粒子在头颈部腺样囊性癌综合治疗中的作用
The effect of 125I seed in comprehensive therapy of the head and neck adenoid cystic carcinoma
-
摘要: 腺样囊性癌(ACC)常发生于头颈部,临床上大多数患者均采用手术结合放疗的综合治疗方法。手术联合放疗可达到较好的局部控制率,尤其是对手术无法切除的晚期恶性肿瘤,而放疗可缓解局部症状、延缓肿瘤发展。125I粒子植入治疗是一种有效的近距离放疗方法,可一次性完成插植,具有周围正常组织损伤轻微、靶区定位准确和操作简单的特点。125I粒子可在CT、B超、导航等影像设备的引导下植入肿瘤。应用125I粒子植入治疗头颈部ACC已经取得了良好的近期疗效,不良反应的发生率较低。术前制定治疗计划、术中或术后进行质量验证,可保证治疗质量可靠,最好地发挥125I粒子植入治疗的作用。Abstract: Adenoid cystic carcinoma(ACC)often occurs in head and neck, many patients are treated with surgical operation combined radiation treatment method in clinic.Surgery combined radiation therapy can achieve good local control, especially for those late-stage cancer undlgo patients who cannot undergo surgical resection.Radiation therapy can alleviate local symptoms, retards the growth of tumor. 125I seed interstitial brachytheraphy is an effective treatment method which has the characteristics of minimal damage in normal tissue, accurate positioning in target area and simple operation, and it can be one-time completed.125I seed can be implanted in tumors through the CT, B ultrasonic and image navigation equipment.Application of 125I seed interstitial brachytheraphy treatment in head and neck ACC has achieved good short-term curative effect. Preoperative establishing treatment plan and intraoperative or postoperative quality verification can guarantee the qualityoftreatment and make 125I seed interstitial brachytheraphywork better.
-
Key words:
- Carcinoma, adenoid cystic /
- Iodine radioisotopes /
- Brachytherapy
-
[1] 赵锦, 许素玲. 头颈部腺样囊性癌放射治疗30例分析及文献复习. 肿瘤防治杂志, 2000, 7(2): 154-155. doi: 10.3969/j.issn.1673-5269.2000.02.017
[2] 赵科, 罗洪, 吴亚东, 等. 放射性125I粒子组织间植入近距离治疗唾液腺恶性肿瘤的初步报告. 中国实验方剂学杂志, 2010, 16(14): 189-191. doi: 10.3969/j.issn.1005-9903.2010.14.060
[3] 吕淑珍, 张杰, 赵京华. 联合术后放射性粒子125I组织间植入治疗涎腺腺样囊性癌的初步观察. 现代口腔医学杂志, 2009, 23(5): 550-551. doi: 10.3969/j.issn.1003-7632.2009.05.031
[4] 刘琳, 何彦津. 泪腺腺样囊性癌的放射治疗. 国际眼科杂志, 2004, 4(5): 900-904. doi: 10.3969/j.issn.1672-5123.2004.05.031
[5] 张杰, 张建国, 宋铁砾, 等. 经CT引导头颈部恶性肿瘤125I放射性粒子的植入. 华西口腔医学杂志, 2008, 26(1): 8-14. doi: 10.3321/j.issn:1000-1182.2008.01.003
[6] 彭诚, 邓嘉胤, 王东, 等. 放射性核素125I粒子植入治疗晚期腺样囊性癌[J/CD]. 中华口腔医学研究杂志(电子版)2008, 2(3): 270-276.
[7] 袁航, 任统伟, 胡元合, 等. CT导向下125Ⅰ粒子组织间种植治疗头颈部肿瘤的临床研究. 医学研究杂志, 2009, 38(10): 111-112. doi: 10.3969/j.issn.1673-548X.2009.10.043
[8] 李树玲. 新编头颈肿瘤学. 北京: 科学技术文献出版社, 2002: 455-457.
[9] 唐东润, 宋国祥, 孙丰源, 等. 眼眶泪腺腺样囊性癌手术联合放疗的疗效观察. 眼科研究, 2002, 20(1): 69-71.
[10] Prokopakis EP, Snyderman CH, Hanna EY, et al. Risk factors for local recurrence of adenoid cystic carcinoma: the role of postoperative radiation therapy. Am J Otolaryngol, 1999, 20(5): 281-286. doi: 10.1016/S0196-0709(99)90028-5 [11] Kim KH, Sung MW, Chung PS, et al. Adenoid cystic carcinoma of the head and neck. Arch Otolaryngol Head Neck Surg, 1994, 120(7): 721-726. doi: 10.1001/archotol.1994.01880310027006 [12] 王俊杰, 修典荣, 冉维强. 放射性粒子组织间近距离治疗肿瘤. 2版. 北京: 北京大学医学出版社, 2004: 18-51.
[13] 王俊杰, 冉维强, 袁惠书, 等. 放射性125I粒子植入治疗头颈部肿瘤. 中华放射医学与防护杂志, 2006, 26(1): 23-26. doi: 10.3760/cma.j.issn.0254-5098.2006.01.008
[14] 张建国, 张杰, 宋铁砾, 等. 放射性粒子组织间植入治疗口腔颌面部恶性肿瘤初探. 中华口腔医学杂志, 2006, 41(8): 464-466. doi: 10.3760/j.issn:1002-0098.2006.08.005
[15] Zhang J, Zhang JG, Song TL, et al. 125I seed implant brachytherapyassisted surgery with preservation of the facial nerve for treatment of malignant parotid gland tumors. Int J Oral Maxillofac Surg. 2008, 37(6): 515-520. [16] 张涛, 张福君, 焦德超, 等. 125I粒子组织间植入治疗头颈部复发和转移恶性肿瘤. 中国微创外科杂志, 2008, 8(5): 445-447. doi: 10.3969/j.issn.1009-6604.2008.05.025
[17] Shields JA, Shields CL, Freire JE, et al. Plaque radiotherapy for selected orbital malignancies: preliminary observations: the 2002MontgomeryLecture, part2. Ophthal Plast Reconstr Surg, 2003, 19(2): 91-95. doi: 10.1097/01.IOP.0000056020.66654.33 [18] Storey MR, Landgren RC, Cottone JL, et al. Transperineal 125 iodine implantation for treatment of clinically localized prostate cancer: 5-year tumor control and morbidity. Int J Radait Oncol Biol Phys, 1999, 43(3): 565-570. doi: 10.1016/S0360-3016(98)00451-9
计量
- 文章访问数: 1771
- HTML全文浏览量: 594
- PDF下载量: 2