Shibuya Hitoshi
Department of Radiology, Tokyo Medical and Dental University Hospital, Tokyo, Japan.
Int J Clin Oncol. 2009 Feb;14(1):2-6. doi: 10.1007/s10147-008-0859-y. Epub 2009 Feb 20.
Brachytherapy delivers a high radiation dose to a limited volume while sparing surrounding normal tissues. In head and neck cancer, severe soft-tissue damage and bone damage to the mandible has decreased markedly since the introduction of computer dosimetry and the use of spacers during treatment. For the curative treatment of head and neck cancer, the selection of brachytherapy sources from among the several linear and small permanent implant sources available, not only according to the tumor site but also according to the patient's physical and mental condition is important. Following the successful treatment of early head and neck cancer by brachytherapy, two major problems and one minor problem may confront the physician. The major problems are neck node metastasis and a second primary cancer of the respiratory tract or upper digestive tract, and the minor problem is radiation-induced cancer.
近距离放射治疗可在保护周围正常组织的同时，向有限体积的区域给予高剂量辐射。在头颈癌治疗中，自引入计算机剂量测定法以及在治疗期间使用间隔物以来，下颌骨的严重软组织损伤和骨损伤已显著减少。对于头颈癌的根治性治疗，从几种可用的线性和小型永久性植入源中选择近距离放射治疗源很重要，这不仅要根据肿瘤部位，还要根据患者的身心状况。在通过近距离放射治疗成功治疗早期头颈癌后，医生可能会面临两个主要问题和一个次要问题。主要问题是颈部淋巴结转移以及呼吸道或上消化道的第二原发性癌症，次要问题是辐射诱发的癌症。
