Geiger Matthias, Strnad Vratislav, Lotter Michael, Sauer Rolf
Department of Radiation Therapy, University Erlangen-Nuremberg, Erlangen, Germany.
Brachytherapy. 2002;1(3):149-53. doi: 10.1016/s1538-4721(02)00056-9.
We attempted in our clinic to evaluate the efficacy and feasibility of a simultaneous application of a cis-platinum-based chemotherapy and interstitial hyperthermia to interstitial pulsed-dose rate (PDR) brachytherapy in patients with recurrent head-and-neck cancer.
Between April 1999 and September 2001, 15 patients with recurrent head-and-neck cancer were treated with PDR brachytherapy, chemotherapy, and interstitial hyperthermia. All patients had received prior radiation therapy. A dose per pulse of 0.46 to 0.55 Gy was given up to a median total dose of 55 Gy. Simultaneously to the PDR brachytherapy, chemotherapy was given with cis-platinum 20 mg/m2 as a short i.v. infusion each day and 5-fluorouracil 800 mg/m2 by continuous infusion from Day 1 to Day 5. After the PDR brachytherapy was finished, all patients were treated with a single session of interstitial hyperthermia.
All the patients could receive the whole treatment. After treatment, only mild oral mucositis occurred. One patient developed soft tissue ulceration. None of the patients developed osteoradionecrosis. After a median follow-up of 6 months, the local tumor control rate was 80% (12 of 15), and the 2-year overall survival was 67% (10 of 15).
The intensification of the interstitial PDR brachytherapy with chemotherapy and hyperthermia is feasible and safe, and the preliminary results are encouraging.
我们在诊所尝试评估顺铂类化疗与间质热疗同时应用于复发性头颈癌患者的间质脉冲剂量率（PDR）近距离放射治疗的疗效和可行性。
1999年4月至2001年9月期间，15例复发性头颈癌患者接受了PDR近距离放射治疗、化疗和间质热疗。所有患者均曾接受过放疗。每次脉冲剂量为0.46至0.55 Gy，中位总剂量达55 Gy。在进行PDR近距离放射治疗的同时，给予化疗，顺铂20 mg/m²，每日短时间静脉输注，5-氟尿嘧啶800 mg/m²，从第1天至第5天持续输注。PDR近距离放射治疗结束后，所有患者接受单次间质热疗。
所有患者均能完成整个治疗。治疗后，仅出现轻度口腔黏膜炎。1例患者发生软组织溃疡。无患者发生放射性骨坏死。中位随访6个月后，局部肿瘤控制率为80%（15例中的12例），2年总生存率为67%（15例中的10例）。
化疗和热疗强化间质PDR近距离放射治疗是可行且安全的，初步结果令人鼓舞。
