梁云  邹秀珍

[摘要] 目的 探讨CT导向下经皮125I放射性粒子植入治疗鼻咽癌的临床疗效。 方法 对10例确诊鼻咽癌的患者行CT导向下经皮植入125I放射性粒子，分析治疗效果，研究其临床应用的可行性。 结果 10例患者共植入粒子760颗。治疗后4周复查，CR 7例（70%），PR 2例（20%），总有效率达到90%，所有患者均未发生严重并发症。8周后复查，3例患者出现新病灶，分别补充植入60、30、40粒，1例患者死于肝转移。 结论 CT导向下125I粒子植入治疗晚期鼻咽癌是一种安全、可靠、疗效较好的治疗方法。

[关键词]晚期鼻咽癌；125I粒子；CT导向

[中图分类号] R730.5   [文献标识码] A   [文章编号] 2095-0616（2014）09-211-03

Clinical observation of brachytherapy with radioactive 125I seeds on advanced nasopharyngeal carcinoma with CT guidance

LIANG Yun  ZOU Xiuzhen

People's Hospital of Yangshan County, Yangshan 513100, China

[Abstract] Objective To evaluate the efficacy of brachytherapy with radioactive 125I seeds on advanced nasopharyngeal carcinoma by CT guidance. Methods The 10 patients of advanced nasopharyngeal carcinoma were treated with 125I seeds implantation by CT guidance, then analyze the treatment effect, and study the feasibility of clinical application. Results Totally 760 seeds were implanted in 10 patients. After four weeks, the check result was, in all 10 cases, 7 patients had complete response (CR), 2 patients had partial response(PR), total effective rate (CR + PR) was 90.00%. All patients had no serious postoperative complications. Eight weeks later, new focus was found in 3 patients, and were added into 3 patients with 60, 30, 40 seeds. 1 patient died of liver metastasis. Conclusion Brachytherapy with radioactive 125I seeds on advanced nasopharyngeal carcinoma by CT guidance was effective， safe and reliable.

[Key words] Advanced nasopharyngeal carcinoma; 125I seeds; CT guidance

鼻咽癌又称为广东癌，在广东的发病率一直居高不下，且早期不易发现，待发现时多为中晚期患者[1]。由于鼻咽周围紧邻脑干、脊髓、视角差、视神经等重要组织和器官，故手术和放疗均会受到一定的限制，常规放疗为其首选治疗手段，但体外照射在治疗疾病的同时，会导致多种放疗后遗症，如放射性脑病、口干、张口困难等，对患者的生存质量造成较大影响疗效常不理想[2]。组织间内照射是新兴的恶性肿瘤治疗手段，其中，125I放射性粒子永久性植入是近几年来开展起来的辅助治疗肿瘤的新方法。国内外多项研究均表明[3]，放射性粒子组织间种植为鼻咽癌的治疗提供了一种安全、有效、并发症少的微创治疗方式。张建国等[4]研究也表明，放射性粒子组织间植入近距离放疗治疗头颈部恶性肿瘤，效果较好。2013年1月～12月，我科在CT引导下对10例肺癌患者行125I放射性粒子植入术，取得较好的疗效，现将相关情况报道如下。……