| Objective:Through the analysis and summary of the clinical application of 125I radioactive seeds implantation in the treatment of oral and maxillofacial malignant tumors.The survival,complications and side effects of 125I seed implantation in patients with maxillofacial malignant tumors were analyzed,and the prognosis was evaluated.The purpose of this study is to summarize and analyze the clinical application of 125I radioactive particles in the treatment of oral and maxillofacial malignant tumors,so as to provide basis for the choice of treatment plan of clinical malignant tumors.Methods:1.Inclusion criteria:patients receiving radioactive 125I seed implantation after resection of oral and maxillofacial malignant tumor in the Yijishan Hospital,Wannan Medical College from October 2011 to October 2019 were selected2.Diagnostic criteria:All patients were diagnosed with CT、Doppler ultrasound or MRI imaging;the conventional postoperative pathological report by the department od pathology was clearly diagnosed as cancerous lesions,which met the diagnostic criteria for maxillofacial malignant tumors.3.Medical history collection:Preoperative medical history of patient and past history and specialist examination were recorded;postoperative vital signs,postoperative symptoms,symptom outcome after the appearance of symptoms and corresponding measures were recorded;follow-up of the patient after discharge.4.statistical analysis:SPSS 18.0 statistical software was used for data analysis.The measurement data were expressed by?x±s,the components by t-test,the classification data by case number or percentage,the comparison between groups byχ2 test or Fisher exact probability method or rank sum test,the survival analysis by Kaplan Meier and the survival curve were drawn,and the influencing factors were analyzed comprehensively by multivariate Cox regression model（forward method）.Results:1.42 patients with malignant tumor successfully completed the operation of 125I radioactive seeds implantation under the guidance of ultrasound,with an average of 57.52seeds implanted（29 at least and 81 at most）.There were 23 males and 19 females,ranging in age from 25 to 78 years,with an average age of（54.52±12.29）years.The average length of stay was 3.5 days.According to the pathological results,37 cases of maxillofacial malignant tumors were adenocarcinoma(adenoid cystic carcinoma 30 cases（71.43%）,moderately differentiated adenocarcinoma 1 case（2.38%）,low-grade cribriform cystic carcinoma 1 case（2.38%）,ductal carcinoma 1 case（2.38%）,mucoepidermoid carcinoma 2cases（4.76%）,acinar cell carcinoma 1 case（2.38%）,myoepithelial carcinoma 1 case（2.38%）;squamous cell carcinoma 5 cases（11.90%）。According to the location of lesions,32 cases were located in parotid gland（76.19%）,3 cases in tongue（7.14%）,3 cases in submandibular gland（7.14%）,1 case in oropharyngeal region（2.38%）,2 cases in gingiva（4.76%）,1 case in buccal region（2.38%）.2.The mean follow-up time was 43.952±4.64 months,the longest was 89 months,the shortest was 3 months;the mean survival time was 67.62 months（95%CI:59.40-75.85）;the median survival time was 73.00 months（95%CI:61.08-84.92）,the three-year survival rate was 87.7%,and the five-year survival rate was 65.8%.In this study,37 patients with adenocarcinoma were included,the mean survival time was 69.51 months（95%CI:60.40-78.62）,the median survival time was 73 months;5 patients with squamous carcinoma,the mean survival time was 57.25 months（95%CI:42.32-72.18）,the median survival time was 61 months.3.The difference was statistically significant（P<0.05）in the survival time of maxillofacial malignant tumor patients with age≤60 years old and without combined basic diseases,but there was no significant difference in the survival time of maxillofacial tumor classification,gender,implanted particles,adverse reactions and complications（P>0.05）.4.Cox regression analysis showed that age>60 years old（HR=8.646,95%CI:2.208-33.858）and basic diseases（HR=4.965,95%CI:1.065-23.150）were the risk factors for the prognosis of patients with maxillofacial malignant tumors.5.There were 3 cases of fever,6 cases of pain at the puncture site,2 cases of particle displacement,2 cases of nerve injury,1 case of mouth opening limitation,1 case of dry mouth symptom,11 cases of acute radiation skin injury（including 8 cases of grade I and 3cases of grade II）;while there were 3 cases of fever,pain at the puncture site and particle displacement in the gland and squamous cell carcinoma of maxillofacial region after particle implantation There was no significant difference in the incidence of complications and adverse reactions among the three groups（P>0.05）.Conclusion:1、The operation combined with 125I radioactive seed implantation can prolong the survival time and improve the survival rate of maxillofacial malignant tumor,and its clinical effect is significant.2..The survival time of maxillofacial cancer patients with age≤60 years old and without combined basic diseases was higher than that of patients with age>60 years old and combined basic diseases,but there was no significant difference in maxillofacial tumor classification,gender,implantation particle number,adverse reactions and complications.3.Age>60 years old and basic diseases are the risk factors for the prognosis of patients with maxillofacial malignant tumors.4.The operation is simple,safe,the average hospitalization time is short,the side effects and postoperative complications are light,and it is not easy to have serious complications. |
