Strnad V, Lotter M, Grabenbauer G, Sauer R
Department of Radiation Therapy, University Erlangen-Nürnberg, Erlangen, Germany.
Int J Radiat Oncol Biol Phys. 2000 Jan 1;46(1):27-30. doi: 10.1016/s0360-3016(99)00417-4.
The aim of this study was to evaluate the relative incidence of toxicity and local control in patients with head and neck malignancies who underwent interstitial pulsed-dose-rate (PDR) brachytherapy (iBT).
From October 1997 to December 1998, 61 patients underwent interstitial PDR brachytherapy procedures in our department; 47 were patients with head and neck cancer. Forty patients received brachytherapy as part of their curative treatment regimen, and 7 patients were implanted for palliative purposes and excluded from the analysis of therapy efficacy. Twenty-four patients had interstitial brachytherapy procedures alone with D(REF) = 50 Gy; in 23 patients, iBT procedures were performed with D(REF) = 24 Gy in combination with external radiation. A dose per pulse (dp) of 0.5 Gy was prescribed for 38/47 patients, and a dp = 0.7 Gy for 9/47 patients. The pulses were delivered 24 h a day, with a time interval of 1 h between two pulses, resulting in an effective dose rate of 0.5 Gy/h or 0.7 Gy/h. A follow-up of the patients was done to analyze acute and delayed toxicity, local control, and survival. The analysis was performed after median follow-up of 12 months (5-18 months).
After a median follow-up of 12 months, soft tissue necrosis was seen in one patient and bone necrosis in another. No other serious side effects were observed. Permanent locoregional tumor control was achieved in 37 of 40 patients. No distant metastases were observed.
PDR interstitial brachytherapy with 0.5-0.7 Gy/h is a safe therapy. These preliminary results suggest that PDR interstitial brachytherapy of head and neck cancer is comparable with low-dose-rate (LDR) brachytherapy.
本研究旨在评估接受组织间脉冲剂量率（PDR）近距离放射治疗（iBT）的头颈部恶性肿瘤患者的毒性相对发生率和局部控制情况。
1997年10月至1998年12月，我科61例患者接受了组织间PDR近距离放射治疗；其中47例为头颈部癌患者。40例患者接受近距离放射治疗作为其根治性治疗方案的一部分，7例患者因姑息治疗目的植入，被排除在治疗疗效分析之外。24例患者仅接受组织间近距离放射治疗，D(REF)=50 Gy；23例患者接受D(REF)=24 Gy的iBT治疗并联合外照射。47例患者中有38例的每脉冲剂量（dp）为0.5 Gy，9例为dp = 0.7 Gy。脉冲每天24小时给予，两个脉冲之间的时间间隔为1小时，有效剂量率为0.5 Gy/h或0.7 Gy/h。对患者进行随访以分析急性和迟发性毒性、局部控制及生存率。在中位随访12个月（5 - 18个月）后进行分析。
中位随访12个月后，1例患者出现软组织坏死，另1例出现骨坏死。未观察到其他严重副作用。40例患者中有37例实现了永久性局部肿瘤控制。未观察到远处转移。
0.5 - 0.7 Gy/h的PDR组织间近距离放射治疗是一种安全的治疗方法。这些初步结果表明，头颈部癌的PDR组织间近距离放射治疗与低剂量率（LDR）近距离放射治疗相当。
