Köhler-Brock A, Prager W, Pohlmann S, Kunze S
Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Universität Leipzig.
Strahlenther Onkol. 1999 Apr;175(4):170-4.
In our department we have developed a standardized applicator for HDR brachytherapy of surface lesions, the so called Leipzig-applicator. We have used this method since September 1987, initially with a Decatron remote afterloading machine, but more recently from November 1990 with a microSelectron-HDR. We report about our experience of 10 years.
Since 1987 we treated 520 patients in 3,026 fractions with this method. In most of the cases we irradiated tumors of the skin of the face, but we also treated tumors of the mouth, of the tongue, of the perianal region and the external genitalia. The histological types were in most of the cases squamous cell carcinomas and basal cell carcinomas, but we also treated tumors like Kaposi-sarcomas, melanomas and skin manifestations of lymphomas and solid organ tumors. We also irradiated benign lesions like keloids after excision. We use single doses between 5 and 10 Gy once to twice a week. The isodose distribution was depending of the tissue infiltration of the tumor. The total dose was 30 to 40 Gy.
In 91% of the cases we obtained a complete remission of the tumor, in 6% a partial remission. Recurrences appeared in 8% of the patients. In most cases the reason of the recurrence was a lower brachytherapy dose because of a prior radiotherapy. We didn't observe any severe late radiation reaction.
We consider that our series of patients treated with HDR brachytherapy and a range of standardized applicators demonstrates that this is a successful method of treating surface lesions.
在我们科室，我们开发了一种用于体表病变高剂量率近距离放疗的标准化施源器，即所谓的莱比锡施源器。自1987年9月以来我们一直使用这种方法，最初使用的是Decatron遥控后装治疗机，但最近自1990年11月起使用的是microSelectron - HDR。我们报告我们10年的经验。
自1987年以来，我们用这种方法治疗了520例患者，共3026次分割照射。在大多数情况下，我们照射面部皮肤肿瘤，但也治疗口腔、舌、肛周区域和外生殖器的肿瘤。组织学类型在大多数情况下为鳞状细胞癌和基底细胞癌，但我们也治疗如卡波西肉瘤、黑色素瘤以及淋巴瘤和实体器官肿瘤的皮肤表现等肿瘤。我们还在切除后照射如瘢痕疙瘩等良性病变。我们每周使用1至2次，单次剂量为5至10 Gy。等剂量分布取决于肿瘤的组织浸润情况。总剂量为30至40 Gy。
在91%的病例中肿瘤完全缓解，6%为部分缓解。8%的患者出现复发。在大多数情况下，复发的原因是由于先前的放疗导致近距离放疗剂量较低。我们未观察到任何严重的晚期放射反应。
我们认为，我们用高剂量率近距离放疗和一系列标准化施源器治疗的患者系列表明，这是一种治疗体表病变的成功方法。
