Guinot Jose Luis, Santos Miguel, Tortajada Maria Isabel, Carrascosa Maria, Estellés Enrique, Vendrell Juan Bosco, Muelas Rodrigo, Chust Maria Luisa, Mengual Jose Luis, Arribas Leoncio
Department of Radiation Oncology, Fundación Instituto Valenciano de Oncología (IVO), Valencia, Spain.
Brachytherapy. 2010 Jul-Sep;9(3):227-34. doi: 10.1016/j.brachy.2009.10.003. Epub 2010 Jan 29.
To evaluate the results of high-dose-rate (HDR)-interstitial brachytherapy (ISBT) in oral tongue carcinomas.
Between September 1999 and August 2007, 50 patients were treated for oral tongue carcinoma with HDR-ISBT. The patient's mean age was 58 years. Forty-two patients were in T1-2 stage and 8 patients were in T3 stage; 16 patients were in N+ stage and 34 patients in N0 stage. Exclusive ISBT was given to 17 patients (34%) in T1-2 N0 stage and complementary to external beam radiotherapy (EBRT) to 33 patients (66%). A perioperative technique was performed on 14 patients. The median total dose was 44 Gy when HDR was used alone (4 Gy per fraction) and 18 Gy when complementary to 50 Gy EBRT (3 Gy per fraction).
The median followup was 44 months. Actuarial disease-free survival rates at 3 and 5 years were 81% and 74%, respectively. Local failure developed in 7 patients. Actuarial local control (LC) rates were 87% and 79% at 3 and 5 years in T1-2 stage 94.5% and 91% and T3 stage 43% and 43% (with salvage surgery). Exclusive HDR cases showed LC in 100% of the cases, and the combined group (EBRT+HDR) showed LC in 80% and 69% of the cases at 3 and 5 years (p=0.044). Soft-tissue necrosis developed in 16% and bone necrosis in 4% of the cases.
HDR brachytherapy is an effective method for the treatment of oral tongue carcinoma in low-risk cases. Doses per fraction between 3 and 4 Gy yield LC and complication rates similar to low-dose rate. The perioperative technique promises encouraging results.
评估高剂量率（HDR）组织间近距离放射治疗（ISBT）在口腔舌癌中的治疗效果。
1999年9月至2007年8月期间，50例口腔舌癌患者接受了HDR-ISBT治疗。患者的平均年龄为58岁。42例患者处于T1-2期，8例患者处于T3期；16例患者处于N+期，34例患者处于N0期。17例（34%）T1-2 N0期患者接受单纯ISBT治疗，33例（66%）患者接受外照射放疗（EBRT）联合ISBT治疗。14例患者采用围手术期技术。当单独使用HDR时，中位总剂量为44 Gy（每次分割剂量4 Gy），与50 Gy EBRT联合使用时（每次分割剂量3 Gy）为18 Gy。
中位随访时间为44个月。3年和5年的无病生存率分别为81%和74%。7例患者出现局部复发。T1-2期3年和5年的精算局部控制（LC）率分别为87%和79%，T3期分别为94.5%和91%以及43%和43%（行挽救性手术）。单纯HDR病例的LC率为100%，联合组（EBRT+HDR）在3年和5年时的LC率分别为80%和69%（p=0.044）。16%的病例出现软组织坏死，4%的病例出现骨坏死。
HDR近距离放射治疗是治疗低风险口腔舌癌的有效方法。每次分割剂量在3至4 Gy之间时，LC率和并发症发生率与低剂量率相似。围手术期技术有望取得令人鼓舞的结果。
