Bhatnagar Ajay
Department of Radiation Oncology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Brachytherapy. 2013 Mar-Apr;12(2):134-40. doi: 10.1016/j.brachy.2012.08.003. Epub 2013 Jan 9.
We report clinical outcomes at 1 year or more after high-dose-rate (HDR) electronic brachytherapy (EBT) using surface applicators for the treatment of nonmelanoma skin cancer (NMSC).
From July 2009 to April 2012, 122 patients with 171 NMSC lesions were treated with EBT to a dose of 40Gy in eight fractions, delivered twice weekly. At followup, patients were assessed for acute and late toxicities, cosmesis, and local control.
Treatment of 171 lesions was completed in 122 patients with a mean age 73 years. There have been no recurrences to date with a mean followup of 10 months (range, 1-28 months). Followup data at 1 year or more were available for 46 lesions in 42 patients. Hypopigmentation (all Grade 1) was present in 5 (10.9%) of 46 lesions at 1 year. Other late effects at 1 year included dry desquamation, alopecia, and rash dermatitis, which occurred in 1 (2.2%), 1 (2.2%), and 3 (6.5%) of 46 lesions, respectively. No Grade 3 or higher adverse events were observed at any time point. Cosmesis was evaluated at 1 year for 42 of 46 lesions and was excellent for 39 (92.9%) and good for 3 (7.1%) of the 42 evaluable lesions.
Treatment of NMSC with HDR EBT using surface applicators was effective with no recurrences, good to excellent cosmesis, and acceptable toxicities at 1 year or more after treatment. HDR EBT provides a convenient nonsurgical treatment option for NMSC patients.
我们报告了使用表面施源器进行高剂量率（HDR）电子近距离放射治疗（EBT）治疗非黑色素瘤皮肤癌（NMSC）1年及以上后的临床结果。
2009年7月至2012年4月，122例患有171处NMSC病变的患者接受了EBT治疗，剂量为40Gy，分8次给予，每周两次。随访时，评估患者的急性和晚期毒性、美容效果和局部控制情况。
122例平均年龄73岁的患者完成了171处病变的治疗。截至目前，平均随访10个月（范围1 - 28个月），无复发情况。42例患者的46处病变有1年及以上的随访数据。1年时，46处病变中有5处（10.9%）出现色素减退（均为1级）。1年时的其他晚期效应包括干性脱屑、脱发和皮疹性皮炎，分别发生在46处病变中的1处（2.2%）、1处（2.2%）和3处（6.5%）。在任何时间点均未观察到3级或更高等级的不良事件。对46处病变中的42处进行了1年时的美容效果评估，42处可评估病变中，39处（92.9%）效果极佳，3处（7.1%）效果良好。
使用表面施源器的HDR EBT治疗NMSC有效，治疗后1年及以上无复发，美容效果良好至极佳，毒性可接受。HDR EBT为NMSC患者提供了一种便捷的非手术治疗选择。
