目的：探讨单纯125I粒子治疗后头颈部腺源性癌远处转移的一般规律。方法：2002年至2010年就诊于北京大学口腔医院口腔颌面外科的头颈部腺源性癌患者43例，因全身或局部因素不能进行手术切除，行单纯125I放射性粒子组织间植入治疗，肿瘤部位包括腮腺、颅底颞下窝、舌、上颌、咽旁、口底、颌下、唇。术后随访观察，统计局部控制率、生存率及远处转移情况。结果：远处转移率为53.5%（23/43）；转移发生时间为5~96个月，平均时间（27.0±23.7）个月，中位时间21个月；肺为最常见转移部位（16/23，69.6%）；远处转移常见病理类型为腺样囊性癌（14/23，60.9%）和非特异性腺癌（7/23，30.4%）。最终死亡26例，其中18例因转移而死亡，占所有死亡患者的69.2%（18/26）。27例获得了肿瘤完全消退（完全缓解，complete remission，CR），12例消退大于50%（部分缓解，partial remission，PR），2例消退小于50%，2例无效，有效率（CR+ PR）为90.7%。3年局部控制率和生存率分别为60.1%和82.6%，5年分别为53.4%和56.0%。结论：对于手术禁忌或无法切除的头颈部腺源性癌，单纯125I放射性粒子组织间植入可以取得良好的近期疗效，但远期疗效仍有待进一步观察。远处转移是治疗失败的主要原因，肺为最常见的部位。

Objective： To investigate clinical features of distant metastases from malignant salivary gland carcinomas after treated by 125I internal brachy therapy alone. Methods: Between 2002 and 2010, 43 patients with locally advanced unresectable or recurrent malignant salivary gland carcinomas were treated by 125I internal brachy therapy alone at Peking University School and Hospital of Stomatology. All of them had been follow-up at least 2 years. The primary sites of malignant salivary gland carcinomas were the parotid for 12 patients, infratemporal fossa for 9 patients, tongue for 7 patients, maxilla for 6 patients, parapharyngeal for 4 patients, floor of months for 3 patients, submandibular gland for 1 patient, and lip for 1 patient. The overall survival rate, local control rate, and distant metastases were retrospectively reviewed. Results: Distant metastases occurred in 23 of the 43 patients (53.5%). Distant metastases developed from 5 to 96 months, with an average interval of (27.0±23.7) months from the time of initial diagnosis, the mean interval was 21 months. The commonest site of distant metastases overall was the lung 69.6%(16/23). The most common pathological types of distant metastases were adenoid cystic carcinoma (14/23, 60.9%) and nonspecific adenocarcinoma (7/23, 30.4%). At the time of the last follow-up, 26 patients died, and 18 of them due to distant metastases (69.2%, 18/26). In the study, 27 patients got complete remission(CR), 12 got partial remission(PR) more than 50%, 2 less than 50%, and 2 patients were invalid. The effective rate (CR+ PR) was 90.7%. The 3 year loco-regional control rate and survival rate were 60.1%, 82.6%, respectively, and the 5 year’s 53.4% and 56.0%. Conclusion: The 125I brachy therapy is a feasible and effective modality for the treatment of locally advanced unresectable or recurrent malignant salivary gland carcinomas. However, further studies are needed with larger numbers of patients and for a longer follow-up assessment. Distant metastasis was the main cause of treatment failure, and the lung was the most common site of distant metastases.