基于生物靶区的老年局部晚期颌面部腺源性恶性肿瘤近距离放疗效果评价

doi:10.19438/j.cjoms.2026.02.003

摘要/Abstract

摘要： 目的: 探讨基于¹⁸F-FDG PET-CT勾画的生物靶区（biological target volume,BTV）在老年局部晚期颌面部腺源性恶性肿瘤近距离放疗中的应用价值,比较其与增强CT勾画的大体肿瘤区（gross tumor volume,GTV）的差异及对治疗效果的影响。方法: 纳入2019年6月—2022年6月徐州市中心医院18例老年颌面部腺源性恶性肿瘤患者,术前行¹⁸F-FDG PET-CT及颌面部增强CT检查,将影像资料导入近距离治疗计划系统（brachytherapy planning system,BTPS）,分别勾画BTV和GTV。患者随机分为试验组（按BTV植入¹²⁵I粒子）和对照组（按GTV植入）,比较两组靶区体积、术后剂量分布、近期疗效及并发症发生率。结果: BTV体积为（49.15±5.37）cm³,显著小于GTV的（52.36±3.53）cm³（P<0.05）。两组术后D₉₀（靶区达到90%的处方剂量）、D₁₀₀（靶区达到100%的处方剂量）、平均剂量及V₁₀₀（100%靶区体积的处方剂量）差异无统计学意义（P>0.05）。术后12个月,两组有效率分别为100%和100%,临床收益率均为100%,无显著差异（P>0.05）。两组均未出现4级放疗反应,局部症状经对症处理后缓解。结论: 基于¹⁸F-FDG PET-CT 勾画的生物靶区可缩小肿瘤靶区范围,在保证靶区剂量的同时减轻放射性损伤,不影响治疗效果,为老年局部晚期颌面部腺源性恶性肿瘤的近距离放疗提供了更精准的靶区勾画方法。

关键词: 颌面部, 腺源性恶性肿瘤, 近距离放疗, ¹⁸F-FDG PET-CT, 生物靶区, 靶区勾画

Abstract: PURPOSE: To explore the application value of biological target volume(BTV) delineated by ¹⁸F-FDG PET-CT in brachytherapy for elderly patients with locally advanced maxillofacial adenogenic malignant tumors, and to compare the differences from gross tumor volume (GTV) delineated by contrast-enhanced CT and their impacts on treatment outcomes. METHODS: Eighteen elderly patients with maxillofacial adenogenic malignant tumors admitted to Xuzhou Central Hospital from June 2019 to June 2022 were enrolled. Preoperative ¹⁸F-FDG PET-CT and maxillofacial contrast-enhanced CT were performed, and imaging data were imported into the brachytherapy planning system(BTPS) to delineate BTV and GTV, respectively. The patients were randomly divided into the experimental group (implanted with ¹²⁵I seeds according to BTV) and the control group (implanted according to GTV). Target volume, postoperative dose distribution, short-term efficacy, and complications were compared between the two groups. RESULTS: The volume of BTV was (49.15±5.37) cm³, which was significantly smaller than that of GTV[(52.36±3.53) cm³](P<0.05). There were no significant differences in postoperative D₉₀, D₁₀₀, mean dose, and V₁₀₀ between the two groups(P>0.05). Within 12 months after surgery, the effective rates of the two groups were both 100%, and the clinical benefit rates were both 100%, with no significant difference(P>0.05). No grade 4 radiation reactions occurred in either group, and local symptoms were relieved after symptomatic treatment. CONCLUSIONS: The biological target volume delineated by ¹⁸F-FDG PET-CT can reduce the range of tumor target volume, alleviate radiation damage while ensuring target dose, and does not affect the treatment effect, providing a more precise target delineation method for brachytherapy of elderly patients with locally advanced maxillofacial adenogenic malignant tumors.

Key words: Maxillofacial region, Adenogenic malignant tumor, Brachytherapy, ¹⁸F-FDG PET-CT, Biological target volume, Target delineation

中图分类号:

R739.8

丁紫雪, 庄乾伟, 葛良玉, 徐欣晨, 邵翠玲, 孟箭. 基于生物靶区的老年局部晚期颌面部腺源性恶性肿瘤近距离放疗效果评价[J]. 中国口腔颌面外科杂志, 2026, 24(2): 114-121.

Ding Zixue, Zhuang Qianwei, Ge Liangyu, Xu Xinchen, Shao Cuiling, Meng Jian. Study on brachytherapy for elderly local advanced maxillofacial adenogenic malignancies based on biological target area[J]. China J Oral Maxillofac Surg, 2026, 24(2): 114-121.

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