125I粒子植入术在儿童头颈部横纹肌肉瘤的临床应用

Clinical application of 125I particle implantation in children with rhabdomysarcoma of the head and neck

摘要:

目的：评价125I粒子植入术对儿童头颈部横纹肌肉瘤（RMS）的疗效及副作用。方法：以8例(男4例，女4例）头颈部RMS患儿的原发病灶为目标靶区植入125I放射性粒子，其中原发部位为眼睑及眼2例，眼眶4例，鼻腔及鼻翼2例。观察125I粒子植入术对病灶治疗的有效性及副作用。结果：8例患儿平均随访时间为45±17个月，中位随访时间为43个月，病情达到完全缓解5例，部分缓解2例，死亡1例，总生存率为88%（7/8）。植入术后8例（100%）患儿均出现局部色素沉着，其中1例出现角膜混浊，1例出现眼球胀痛，1例出现视力模糊加重，1例出现视力丧失，1例出现鼻腔黏膜破溃出血。除1例角膜混浊及1例视力丧失外，余6例相关副作用经过治疗均好转。结论：125I放射性粒子植入术治疗儿童头颈部RMS治疗价值肯定，虽存在局部副作用，但经对症治疗可缓解。

Abstract:

OBJECTIVE: To study the efficacy and safety of 125I particle implantation in the treatment of rhabdomysarcoma (RMS) of the head and neck in children. METHODS: Eight children (four males and four females) with RMS of the head and neck received 125I particle implantation targeted to the primary lesion area. The primary lesions were noted in eyelids or eyes in two children, in the orbit in four children, and in the nasal cavity or nasal wing in two children. Treatment outcomes and side effects were observed. RESULTS: The follow-up visits averaged 45±17 months (median 43 months) in the eight children receiving 125I particle implantation. Five children achieved a complete remission, 2 children achieved a complete remission and 1 child died. The total survival rate was 88% in the 8 children. Local pigmentation was observed in all eight children (100%). Nubecula (one case), eyeball pain (one case), serious blurred vision (one case), cornea ulcer and blindness (one case) and bleeding of the nasal cavity (one case) were also observed. Except for nubecula and blindness, these side effects were improved by symptomatic treatment. CONCLUSIONS: 125I particle implantation appears to be effective in the treatment of RMS of the head and neck in children. Most treatment-related side effects can be improved by symptomatic treatment.