Jha A K, Prasiko G, Mod M, Srivastava R, Chaurasia P P
BP Koirala Memorial Cancer Hospital, Bharatpur, Chitwan, Nepal.
JNMA J Nepal Med Assoc. 2006 Apr-Jun;45(162):252-7.
Brachytherapy is potentially useful in the treatment of head-and-neck cancers, because most tumor sites, such as the lip, tongue, floor of mouth, tonsil, pharynx, nasopharynx, sinuses, and neck, are accessible for the placement of afterloading applicators and catheters. It has the advantage of delivering a higher radiation dose to the tumor while sparing surrounding normal tissue from radiation. Furthermore, the overall treatment duration is shorter, and the dose distribution confirms to tumor shape. Brachytherapy is used as "monotherapy" for the treatment of small primary tumors or recurrent disease after external beam radiation therapy (EBRT). Small cancers of the lip (less than 2 cm) are treated equally well with surgery or radiation therapy with excellent cosmetic and functional results seen in radiation therapy. We treated an 18-year old male diagnosed as stage I carcinoma lip with curative interstitial brachytherapy. He was treated to a dose of 3 Gy per fraction, two fractions per day at interval of 6 hours between the two fractions for 6 days. He therefore received a total dose of 36 Gy with High Dose Rate (HDR) Brachytherapy, which is equivalent to 58.36 Gy conventional radiotherapy dose. At two months follow, the patient is clinically disease free and has no complaints.
近距离放射治疗在头颈部癌症的治疗中可能具有重要作用,因为大多数肿瘤部位,如唇部、舌部、口腔底部、扁桃体、咽部、鼻咽部、鼻窦和颈部,都可用于放置后装施源器和导管。它的优势在于能向肿瘤输送更高的辐射剂量,同时使周围正常组织免受辐射。此外,总体治疗时间较短,且剂量分布与肿瘤形状相符。近距离放射治疗被用作“单一疗法”,用于治疗小型原发性肿瘤或外照射放疗(EBRT)后的复发性疾病。唇部的小癌症(小于2厘米)采用手术或放射治疗效果相当,放射治疗在美容和功能方面都有出色表现。我们用根治性组织间近距离放射治疗法治疗了一名18岁诊断为I期唇癌的男性患者。他每次接受3 Gy的剂量,每天两次,两次之间间隔6小时,共治疗6天。因此,他通过高剂量率(HDR)近距离放射治疗总共接受了36 Gy的剂量,这相当于58.36 Gy的传统放疗剂量。在两个月的随访中,患者临床无疾病且无不适主诉。