赝复体式放射性粒子布源器治疗11例腭部腺源性恶性肿瘤的疗效观察
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摘要
目的 :评价赝复体式放射性粒子布源器用于腭部腺源性恶性肿瘤患者的术后放射治疗效果。方法 :11例腭部恶性肿瘤患者,经常规手术切除治疗后2周,根据上颌骨缺损的赝复体设计原则,分别制作铸造支架式赝复体。按照放射性粒子植入治疗计划系统的靶区照射剂量设计要求,在近瘤腔的赝复体基托树脂组织面均匀埋植数枚125I放射性粒子。术后随访观察患者的治疗效果及不良反应。采用SPSS 21.0软件包对数据进行统计学分析。结果:11例患者均能坚持配戴赝复体式放射性粒子布源器,无粒子脱落或移位。随访6～24个月,未见肿瘤复发或远处转移。经赝复体修复后,患者语音清晰度、咀嚼效率、生活质量等均显著改善,自我评估全优。结论:采用赝复体式放射性粒子布源器对腭部腺源性恶性肿瘤患者进行术后近距离靶向照射治疗,可以取得较好的临床疗效,改善患者的生活质量,值得推广应用。
PRUPOSE: To evaluate the clinical efficacy of prosthesis-like applicators with radioactive seeds in treatment of palatal glandular malignancy. METHODS: Eleven patients with palatal glandular malignant tumors were treated with surgical resection and postoperative125 I radioactive seed brachytherapy. After resection of the palatal tumors, a prosthesis denture was fabricated for each patient. According to the design of treatment plan system, several125 I radioactive seeds were embedded in the tissue surface of the prosthesis at the same time. All the patients were followed-up for 6 to 24 months and the results were evaluated. SPSS 21.0 software package was used for statistical analysis. RESULTS: Eleven patients could wear prosthesis-like applicators all the time and neither tumor recurrence nor metastasis were found around the target area during the follow-up period. Furthermore, significant improvement was shown in terms of speech,mastication and facial appearance for all patients after prosthesis-like applicator restorations. CONCLUSIONS: For patients with palatal glandular malignant tumors, prosthesis-like applicators with125 I radioactive seed brachytherapy may be effective for preventing recurrence and metastasis of the malignancies and improving the patients' quality of life.
PRUPOSE: To evaluate the clinical efficacy of prosthesis-like applicators with radioactive seeds in treatment of palatal glandular malignancy. METHODS: Eleven patients with palatal glandular malignant tumors were treated with surgical resection and postoperative125 I radioactive seed brachytherapy. After resection of the palatal tumors, a prosthesis denture was fabricated for each patient. According to the design of treatment plan system, several125 I radioactive seeds were embedded in the tissue surface of the prosthesis at the same time. All the patients were followed-up for 6 to 24 months and the results were evaluated. SPSS 21.0 software package was used for statistical analysis. RESULTS: Eleven patients could wear prosthesis-like applicators all the time and neither tumor recurrence nor metastasis were found around the target area during the follow-up period. Furthermore, significant improvement was shown in terms of speech,mastication and facial appearance for all patients after prosthesis-like applicator restorations. CONCLUSIONS: For patients with palatal glandular malignant tumors, prosthesis-like applicators with125 I radioactive seed brachytherapy may be effective for preventing recurrence and metastasis of the malignancies and improving the patients' quality of life.
引文
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[6]冯云枝,冯海兰,吴汉江,等.上颌骨缺损赝复体修复的语音效果评价[J].实用口腔医学杂志,2006,22(5):245-246.
[7]孟庆飞,孟箭.赝复体联合栓道附着体修复单侧上颌骨缺损的临床疗效评价[J].现代口腔医学杂志,2014,28(2):65-68.
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[10]Zhang J,Zhang JG,Song TL,et al.125I seed implant brachytherapy-assisted surgery with preservation of the facial nerve for treatment of malignant parotid gland tumors[J].Int J Oral Maxillofac Surg,2008,37(6):515-520.
[11]黄明伟,张杰,宋铁砾,等.义齿基托布源器治疗颌周恶性肿瘤的初步应用[J].实用口腔医学杂志,2008,24(2):244-247.
[12]谭京,王兵,黄明伟,等.腭部恶性肿瘤近距离放疗中义齿基托布源器的设计与制作[J].北京大学学报(医学版),2011,43(1):145-148.
[13]孟庆华,马永忠,万玲,等.125I放射性粒子植入治疗中工作人员受照剂量测量与分析[J].首都公共卫生,2013,7(5):202-204.
[14]卓水清,陈林,张福君,等.125I放射性粒子植入术后患者周围辐射剂量的监测[J].癌症,2007,26(6):666-668.
[2]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[J].中华口腔医学杂志,2006,41(8):464-466.
[3]Huang MW,Zhang L,Liu SM,et al.125I brachy therapy alone for recurrent or locally advanced adenoid cystic carcinoma of the oral and maxillofacial region[J].Strahlenther Onkol,2013,189(6):502-507.
[4]Stannard CE,Hering E,Hough J,et al.Post-operative treatment of malignant salivary gland tumors of the palate with iodine-125brachytherapy[J].Radiother Oncol,2004,73(3):307-311.
[5]宋铁砾,张建国,于世平,等.放射性粒子定向植入治疗计划系统在口腔颌面部肿瘤中的初步应用[J].现代口腔医学杂志,2005,19(2):126-129.
[6]冯云枝,冯海兰,吴汉江,等.上颌骨缺损赝复体修复的语音效果评价[J].实用口腔医学杂志,2006,22(5):245-246.
[7]孟庆飞,孟箭.赝复体联合栓道附着体修复单侧上颌骨缺损的临床疗效评价[J].现代口腔医学杂志,2014,28(2):65-68.
[8]于世平.肿瘤放射治疗物理学进展[M].北京:北京医科大学出版社,2003:187.
[9]王俊杰.放射性粒子治疗肿瘤临床应用规范[M].北京:北京大学医学出版社,2011:12.
[10]Zhang J,Zhang JG,Song TL,et al.125I seed implant brachytherapy-assisted surgery with preservation of the facial nerve for treatment of malignant parotid gland tumors[J].Int J Oral Maxillofac Surg,2008,37(6):515-520.
[11]黄明伟,张杰,宋铁砾,等.义齿基托布源器治疗颌周恶性肿瘤的初步应用[J].实用口腔医学杂志,2008,24(2):244-247.
[12]谭京,王兵,黄明伟,等.腭部恶性肿瘤近距离放疗中义齿基托布源器的设计与制作[J].北京大学学报(医学版),2011,43(1):145-148.
[13]孟庆华,马永忠,万玲,等.125I放射性粒子植入治疗中工作人员受照剂量测量与分析[J].首都公共卫生,2013,7(5):202-204.
[14]卓水清,陈林,张福君,等.125I放射性粒子植入术后患者周围辐射剂量的监测[J].癌症,2007,26(6):666-668.