目的探讨组织间125I放射粒子植入治疗头颈部恶性肿瘤颈部淋巴结转移的价值。方法对21例头颈部恶性肿瘤颈部淋巴结转移患者进行125I放射粒子植入治疗,术前行TPS(computer-based treatment planning system)计划、根据计划在CT引导局部麻醉下行颈部淋巴结转移瘤125I放射粒子植入、术后复查CT进行质量验证。根据NRS评分对术前术后患者局部疼痛进行评估,按WHO标准对局部肿瘤控制疗效进行评价。结果随访7~29个月,21例患者均成功行手术治疗,术后3个月复查,完全缓解3例(14%)、部分缓解15例(71%)、病变稳定2例(10%)、病变进展1例(5%);6个月、1、2年的局部控制率(局部肿瘤无进展)分别为:84%、65%、39%;NRS疼痛评分术前、术后3个月、6个月分别为:(7.62±0.92)分,(2.81±0.68)分,(2.14±0.39)分(P<0.05)。3例患者术后出现发热,未超过38.5℃,3~5 d内恢复正常;3例皮肤黏膜1级急性放射性损伤,2例皮肤黏膜2级急性放射性损伤,无3~5级皮肤黏膜急性放射性损伤。所有患者未发生大出血、急性肺栓塞、窦道等严重并发症。结论组织间125I放射粒子植入治疗头颈部恶性肿瘤颈部淋巴结转移创伤小,并发症少,局部控制率较高,疼痛缓解明显,为不能手术的晚期头颈部恶性肿瘤颈部淋巴结转移的患者提供了一种新型治疗手段。 Objective To investigate the value of interstitial 125I radioactive particle implantation in the treatment of cervical lymph node metastasis of head and neck malignant tumor. Methods Twenty-one patients with cervical lymph node metastasis of head and neck malignant tumor undergoing 125I radioactive particle implantation were enrolled. TPS (computer-based treatment planning system) program was performed preoperatively. According to the plan, 125I cervical lymph node metastasis under CT guided local anesthesia was planned Radioactive particle implantation, postoperative CT examination for quality verification. The local pain was evaluated according to NRS score before and after surgery. The curative effect of local tumor was evaluated according to WHO standard. Results All patients were followed up for 7 to 29 months. All the 21 patients were successfully treated by surgery. Three months after operation, 3 patients (14%) were completely relieved, 15 (71%) partially relieved and 2 (10%) patients were stable. (5%). The local control rate at 1 month and 2 years after operation was 84%, 65% and 39% at 6 months respectively. The score of NRS pain was 3 before and after operation Month and 6 months were (7.62 ± 0.92) points, (2.81 ± 0.68) points and (2.14 ± 0.39) points respectively (P <0.05). Three patients had fever after operation, which did not exceed 38.5 ℃ and returned to normal within 3-5 days. Three cases of acute mucosal acute radiation injury and two cases of acute dermal and mucosal level 2 radioactive injury showed no grade 3-5 mucosal acute radioactivity damage. All patients did not occur major bleeding, acute pulmonary embolism, sinus and other serious complications. Conclusion 125I radioactive particle implantation in the treatment of cervical lymph node metastases of head and neck malignant tumors is less with less complications, higher local control rate and obvious pain relief. It is an advanced inoperable neck lymph node metastasis of head and neck cancer Patients provide a new treatment.