Ciérvide Raquel, Ramos Luis, Aristu Jose Javier, Montesdeoca Nestor, Martínez-Monge Rafael
Radiation Oncology Division, Department of Oncology, Clínica Universitaria de Navarra, University of Navarre, Pamplona, Navarre, Spain.
Brachytherapy. 2011 Mar-Apr;10(2):159-62. doi: 10.1016/j.brachy.2010.06.007. Epub 2010 Nov 19.
To explore the feasibility of a intraoral mold high-dose rate (HDR) brachytherapy in the treatment of tumors arising in the maxillary antrum after maxillectomy and to describe the dosimetric profile of HDR brachytherapy in such an unusual location.
A customized mold with four 6-French catheters was designed and produced in transparent acrylic resin. The catheters formed a soft loop that allowed the passage of the HDR source. CT-based dose evaluation in several volumes of interest, including the gross tumor volume (GTV) and several organs at risk (OARs), such as the skin of the cheek, eyeball, lens, optic nerve, optic chiasm, and spinal cord was performed.
Treatments were delivered uneventfully. A favorable OAR/GTV ratio was observed. The GTV D(90) was covered by the 3.8 Gy isodose (95% of the prescription isodose of 4 Gy) and the doses received by the OARs varied between 4% and 43% of the prescription isodose for the V1 cc of spinal cord and eyeball, respectively. The only structure that could not be adequately spared was the skin overlying the tumoral lesion that received between 94% and 107% of the prescription isodose (1.0 and 0.5 cm(2) of skin, respectively).
Intraoral mold-based HDR brachytherapy can be used to treat tumors involving the maxillary antrum provided that access is possible through a previous maxillectomy. A dose reduction of 4-43% in several OARs, such as the spinal cord, pituitary gland, optic chiasm, optic nerve, eyeball, and lens, is obtained.
探讨口腔模具高剂量率（HDR）近距离放射治疗在上颌骨切除术后上颌窦肿瘤治疗中的可行性，并描述在这种特殊部位进行HDR近距离放射治疗的剂量分布情况。
设计并制作了一种定制模具，带有四个6法国导管，由透明丙烯酸树脂制成。导管形成一个柔软的环，允许HDR源通过。在几个感兴趣的体积中进行基于CT的剂量评估，包括大体肿瘤体积（GTV）和几个危及器官（OARs），如脸颊皮肤、眼球、晶状体、视神经、视交叉和脊髓。
治疗过程顺利。观察到良好的OAR/GTV比值。GTV D(90)被3.8 Gy等剂量线覆盖（4 Gy处方等剂量线的95%），脊髓和眼球的V1 cc的OARs接受的剂量分别为处方等剂量线的4%至43%。唯一不能充分避开的结构是肿瘤病变上方的皮肤，其接受的剂量为处方等剂量线的94%至107%（分别为1.0和0.5 cm(2)的皮肤）。
基于口腔模具的HDR近距离放射治疗可用于治疗累及上颌窦的肿瘤，前提是通过先前的上颌骨切除术能够进行操作。在几个OARs中，如脊髓、垂体、视交叉、视神经、眼球和晶状体，剂量降低了4%至43%。
