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目的总结手术联合放射性125I粒子植入治疗颈部及躯干部滑膜肉瘤的疗效。方法 2010年5月-2012年5月,收治颈部及躯干部滑膜肉瘤患者4例。男3例,女1例;年龄33~68岁,平均50岁。病变位于颈后部、左颈根部、右腰背部和左肩胛下各1例。病变范围8 cm×6 cm×4 cm~12 cm×10 cm×6 cm。术中避开病变周围重要结构,尽量距病变周围2 cm以上彻底切除,病变切除区植入125I粒子并以皮瓣或肌皮瓣修复,供区植皮修复。结果术后患者皮瓣及植皮均成活,创面均Ⅰ期愈合。4例患者均获随访,随访时间18~36个月,平均26个月。皮瓣存活良好,局部均无肿瘤复发。其中1例于术后18个月因肺转移死亡。结论手术联合放射性125I粒子植入治疗颈部及躯干部滑膜肉瘤安全易行,可有效控制肿瘤局部复发。
Objective To summarize the curative effect of surgical combined radioactive 125I seed implantation for synovial sarcoma in the neck and trunk. Methods From May 2010 to May 2012, 4 patients with synovial sarcoma in the neck and trunk were treated. 3 males and 1 females; aged 33 to 68 years, mean 50 years. Lesions in the back of the neck, left cervical root, right lower back and left subscapular in 1 case. Lesions range 8 cm × 6 cm × 4 cm ~ 12 cm × 10 cm × 6 cm. Surgery to avoid the important structure around the lesion, as far as possible from the lesions around more than 2 cm completely removed, 125I lesion implants implants and flap or myocutaneous flap repair, for the area of skin graft repair. Results The flaps and skin grafts survived in all patients, and all the wounds healed in the first stage. All 4 patients were followed up for 18-36 months with an average of 26 months. Flap survived well, no local tumor recurrence. One of the patients died of lung metastasis 18 months after the operation. Conclusions Surgery combined with radioactive 125I seed implantation in the treatment of synovial sarcoma in the neck and trunk is safe and feasible, which can effectively control the local recurrence of the tumor.