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【目的】观察在 CT 引导下对头颈部复发恶性肿瘤进行放射性125 I 粒子植入治疗后的近期疗效,探讨该治疗技术对头颈部复发恶性肿瘤的可行性和治疗效果。【方法】对70例头颈部恶性肿瘤综合治疗后复发患者,在三维治疗计划系统(TPS)的指导下,实施 CT 引导的放射性125 I 粒子植入手术治疗。术后24~72 h内,对患者进行头颈部 CT 扫描,与 TPS 计划进行比较验证,并通过体积直方图计算实际照射剂量,从而实施补充植入。效果评估主要靠影像学进行评价,术后1~6个月通过 CT 扫描和肿瘤影像学特征进行治疗效果评估,判断疗效。【结果】70例患者中,17例症状完全缓解(CR),38例症状部分缓解(PR),总有效率到达78.6%(55/70)。患者术后均未出现植入粒子移位现象,且副反应较小,未见明显血象下降,无恶心呕吐等消化道反应。对于急性黏膜及皮肤放疗反应,术后仅出现17例Ⅰ/Ⅱ级反应,且无Ⅲ级以上反应。【结论】CT引导的放射性125 I 粒子植入对头颈部复发恶性肿瘤的近期疗效确切,这为经过手术切除或放射治疗后继续复发恶化的头颈部恶性肿瘤患者提供了微创且安全的有效治疗手段,值得广泛普及和推广。“,”Objective]The aim of this study was to evaluate the efficacy of CT guided 1 25 I seed implanta-tion brachytherapy in recurring head and neck carcinoma,in order to support CT guided 1 25 I seed implantation as the major solution for treating recurring head and neck carcinoma.[Methods]Seventy 70 patients with re-curring head and neck carcinoma were selected as the study subjects.Under the directory direction of treating planning system (TPS),CT guided 1 25 I seed implantation brachytherapy was performed.After the implanta-tion,CT scanning of the head and neck region was done carried out within 24 to 72 hours.Post-operational TPS verification was carried out and actual radiation dosage was calculated based on dose volume histogram (DVH).Thus,if necessary,in order to provide basis for any possible additional supplementary implantation were applied.The efficacy of the treatment was mainly evaluated by CT and tumor iconography from one to six months after the brachytherapy operation.[Results]Among the 70 patients with recurring head and neck carci-noma,the efficacy of CT guided 1 25 I seed implantation brachytherapy was substantial.There were 1 7 cases of complete remission (CR)and 38 cases of partial remission (PR),with a total efficacy rate of 78.6%.In addi-tion,1 25 I seed translocation was not observed after the treatment.Side effects for the treatment were minimal, with no observable decline in hemogram or distinct gastrointestinal reactions including nausea and vomiting. For acute radioactive mucosal and skin reactions,there were 1 7 cases of grade Ⅰ/Ⅱ patients reactions and ze-ro none reaction of grade III or higher cases were shown.[Conclusion]The efficacy of CT guided 1 25 I seed im-plantation brachytherapy in recurring head and neck carcinoma was encouraging.For the recurring head and neck carcinoma patients who underwent unsuccessful surgical tumor removal or radiotherapy,CT guided 1 25 I seed implantation brachytherapy can be an effective and safe alternative solution with minimal invasion,sup-porting a more general practice and promotion.