超声引导碘-125粒子植入治疗颈部转移性淋巴结的疗效与安全性分析
本研究回顾性分析29例患者共53枚颈部转移性淋巴结，接受超声引导下碘-125粒子植入治疗，以RECIST 1.1标准评估疗效。结果显示3、6、12个月局部肿瘤控制率分别为90.5%、91.1%、75.9%，1年和2年总生存率分别为55.2%和37.9%，并发症轻微，仅1例（3.4%）皮肤损伤。结论认为该治疗可行、安全、有效，可作为挽救或替代治疗选择。
要点
- 超声引导碘-125粒子植入对颈部转移性淋巴结局部控制率高，12个月仍达75.9%。
- 并发症发生率低，仅3.4%皮肤损伤，其余不良事件轻微可控。
- 样本量小且原发肿瘤异质性大，生存数据需谨慎解读。
核心结论
- 超声引导碘-125粒子植入是治疗颈部转移性淋巴结可行、安全、有效的局部治疗选择，局部肿瘤控制率高且并发症少，可作为挽救或替代治疗。
研究设计与样本
- 回顾性分析2021年1月至2023年12月间29例患者共53枚颈部转移性淋巴结，在超声引导下按预计划剂量分布经皮植入碘-125粒子。
- 治疗后3、6、12个月采用增强CT基于RECIST 1.1标准评估治疗反应，总生存率采用Kaplan-Meier法估计。
诊断标准与关键数值
- 基于增强CT和RECIST 1.1标准评估，3、6、12个月局部肿瘤控制率分别为90.5%、91.1%、75.9%。
- 患者1年和2年总生存率分别为55.2%和37.9%。
临床应用与阅片要点
- 对于颈部转移性淋巴结，超声引导碘-125粒子植入可作为局部治疗选项，尤其适用于临床处理困难者。
- 治疗后应使用增强CT按RECIST 1.1标准定期评估局部控制情况。
局限性
- 样本量小（29例）且原发肿瘤异质性大，生存结果需谨慎解读。
- 为回顾性研究，可能存在选择偏倚。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
OBJECTIVE: This study aimed to evaluate the efficacy and safety of ultrasound-guided radioactive iodine-125 (125I) seed implantation as a local treatment for metastatic cervical lymph nodes.
METHODS: We conducted a retrospective analysis of 29 patients (with a total of 53 metastatic lymph nodes) who underwent the procedure between January 2021 and December 2023. Under ultrasound guidance, 125I seeds were percutaneously implanted according to a pre-planned dose distribution. Treatment response was assessed using contrast-enhanced CT at 3, 6, and 12 months post-implantation, based on RECIST 1.1 criteria. Overall survival was estimated using the Kaplan-Meier method.
RESULTS: All procedures were technically successful. Over a mean follow-up of 15 ± 10.5 months (range: 7-26). Local tumor control rates were 90.5%, 91.1%, and 75.9% at 3, 6, and 12 months, respectively. The 1-year and 2-year overall survival rates for patients were 55.2% and 37.9%; however, these results should be interpreted cautiously due to the small sample size and heterogeneity of primary tumors. The complication profile was favorable, with only one case (3.4%) of skin injury; other adverse events were minor and manageable.
CONCLUSION: Ultrasound-guided 125I seed implantation is a feasible, safe, and effective local treatment option for metastatic cervical lymph nodes, offering high rates of local tumor control with minimal morbidity. It represents a valuable salvage or alternative therapy for this clinically challenging condition.
引用
- Li H, Jiang Y, Li J, et al. Ultrasound-Guided Iodine-125 Seed Implantation for Cervical Metastatic Lymph Nodes: An Analysis of Efficacy and Safety. J Ultrasound Med. 2026. PMID: 42184129. doi:10.1002/jum.70303
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。